MEDICAL  DEPARTMENT 


OF.THE\ 

UNITED  STATES  NAVY 


GIFT  OF 


MANUAL  FOR  THE 

MEDICAL  DEPARTMENT 


OF  THE 


UNITED  STATES  NAVY 


PUBLISHED  BY  THE  BUREAU  OF  MEDICINE  AND  SURGERY 

UNDER   THE    AUTHORITY    OF   THE 

SECRETARY  OF  THE  NAVY 


WASHINGTON 

GOVERNMENT  PRINTING  OFFICE 

1917 


[M.  &  S.  No.  128v)14. 


Bureau  or  Medicine  and  Surgery, 

Navy  Department, 
Washington,  D.  C,  August  1, 1917. 
This  Manual  for  the  Medical  Department  of  the  United  States 
Navy  is  published  for  the  guidance  of  the  Medical  Department. 
Nothing  herein  shall  be  construed  as  superseding,  amendmg,  or  modi- 
fying the  United  States  Navy  Regulations  and  Naval  Instructions; 
and  this  manual  shall  be  subject  to  amendment  by  circulars  issued  by 
the  bureau,  and  by  general  orders  issued  hereafter  by  the  department. 

W.  C.  Braisted, 
Surgeon  General^  U.  &.  Navy. 

Approved : 

JosEPHUS  Daniels, 

Secretary  of  the  Navy, 


368073 


TABLE  OF  CONTENTS. 


Page. 

Chapter  1.  Bureau  of  Medicine  and  Surgery 7 

2.  Medical  Corps - 11 

3.  Dental  Corps ^^ 

4.  Hospital  Corps ^^ 

5.  Nurse  Corps ^^ 

6.  Duties  of  medical  officers  and  dental  officers oi 

7.  Duties  of  the  fleet  surgeon  and  the  division  surgeon ._ 71 

8.  Administration    and    internal    organization    of   naval    hospitals.  75 

Special  hospitals 

9.  NaA-al  hospital  ships 1"'' 

10.  Battle  organization  of  the  Medical  Department  afloat,  and  expe- 

ditionary service  on  shore .- 1"^ 

11.  Physical  examination  of  candidates  for  admission,  appointment, 

and  promotion ; •  ^^^ 

12.  Physical  examination  for  enlistment,  special  duties,  navy-yard  ^ 

8er^•ice,  and  imder  compensation  act 1^3 

13.  Health  record,  nomenclature,  Journal  of  the  Medical   Depart- 

ment, and  reports  of  death ; 15"^ 

14.  Sanitary  regulations  and  reports,  and  sanitary  duties 191 

15.  Bills  of  health,  quarantine,  and  disinfection 203 

16.  Line  of  duty  and  origin  of  disability 213 

17.  Medical  and  material  surveys  and  transfers  of  sick 219 

18.  Insane  of  the  Navy 227 

19.  Naval  Medical  School - .  - 231 

20.  Supplies,  services,  requisitions,  and  public  bills 235 

21.  Invoices,  property  accountability,  outfits  and  supplies,  and  trans- 

fers of  stores 245 

22.  Naval  hospital  fund 249 

23.  Navy  pension  fund  and  general  pensions 253 

24.  Blank  forms 261 

25.  Reports  and  returns 273 

26.  Geneva  and  Hague  peace  conventions  and  the  American  Red  Cross .  285 

5 


M4NUAL  FOR  THE  MEDICAL  DEPARTMENT, 
UNITED  STATES  NAVY. 


CHAPTER  1. 


THE  BUREAU  OF  MEDICINE  AND  SURGERY. 

Section  1.— Laws  Relating  to  the  Establishment  of  Bukeaus  ;  Chiefs  of 
Bureau  and  Assistant  Chiefs  of  Bureau. 

1.  Establishment  of  bureaus.     Sec.  419,  R.  S.^  (R '  103  (1) )  ;  act  Aug  22  1912. 

2.  Custody  of  books  and  records  of  bureaus.     Sec.  420,  R.  S. ;   (R  lOd  (Z)}. 

3.  Appointment  of  chiefs  of  bureaus.  .  Sec.  421,  R.  S. 

4.  Chief  of  Bureau  of  Medicine  and  Surgery.     Sec.  426,  R.  S. 

5.  Staff  officers  who  have  been  chiefs  of  bureau  exempt  from  sea  duty  except 

in  war.     Sec.  1436,  R.  S.  c       ..-.    r,    o         .  at  .    q 

6.  Rank  and  title  of  certain  chiefs  of  bureau.     Sec.  14*1,  R.  S. ;  act  Mar.  6, 

1899 

7.  Rank  of  chiefs  of  bureau  retired.     Sec.  1473,  R.  S. ;  acts  Mar.  3,  1899 ;  May 
13,  1908;  June  24,  1910;  Aug.  22,  1912.  ,^o   -.o-   t>    a 

8.  Assistant  to  Bureau  of  Medicine  and  Surgery.    Sees.  Ii8,  13  (O,  K.  b. 

Section  2.— Navy  Regulations  and  Naval  Instructions  Defining  the  Duties 
OF  the  Bureau  of  Medicine  and  Surgery. 

11.  Bureau  of  Medicine  and  Surgery.     R  133. 

12.  Duties  of  Medical  Department.     R  2901. 

13.  Autliority  of  bureau   to  issue  "Manual   for   the  Medical  Department. 
R  901  (1);;  R  901  (2)  ;  R  901  (3). 

14    Authority  of  bureau  to  publish  and  distribute  "  Drill  Book  for  the  Hos- 
pital'Corps."     I'  602  (6). 

Section  3. — Laws  Relating  to  Estimates. 

21.  Estimates  for  expenses.     Sec.  430,  R.  S. 

22.  Manner  of  communicating  estimates.     Sees.  3660  to  3671,  R.  S. ;  acts  .July 
7.  1884,  sec.  2 ;  and  June  22,  1906,  sec.  4. 

23.  Classification  in  Book  of  Estimates.     Act.  Feb.  23,  1881. 

24.  Requisites  for  estimates  for  appropriations  for  public  works.     Sec.  3663, 

25.  Estimates  to  be  submitted  to  Congress.     Sec.  3669,  R.  S. 

26.  Department  estimates  to  be  furnished  before  October  15,  annually.     Sec. 
5,  act  Mar.  3,  1901. 


1 R.  S.  'ndicates  Revised  Statutes,  edition  of  1878 ;  R  indicates  Regulations  and  I 
indicates  Instructions,  both  referring  to  the  U.  S.  Navy  Regulations  and  >.aval  Instruc- 
tions   1913.     (Regulations  for  the  Government  of  the  Navy  of  the  Lnited  btates,  lyirf.) 

7 


8  MAX  UAL   FOK   THE   MKDICAL  DEPARTMENT,   U.    S.    NAVY. 

27.  Secretary  of  the  Treasury  to  make  estimates  if  none  furnislied.  Sec.  5, 
act  Mar.  o.  lOUl. 

28.  What  statements  shall  accompany  estimates.     Sec.  3670,  R.  S. 
2?).  What  additional  explanations  are  required.     Sec.  3G64,  11.  S. 

30.  Amount  of  outstanding  appropriations  to  be  designated.     Sec.  360.5,  U.  S. 

31.  Items  of  expenditure  to  be  specified  in  estimates  and  accounts.  Sec.  30G6, 
R.  3. 

Section  4. — Instkuctionb  Relating  to  the  Preparation  of  Estimates  (blank 

forms). 

41.  The  Trea.sury  Department  prepares  and  distributes  among  the  several 
executive  departments  a  blank  estimate  form,  covering  the  estimates  of  appro- 
priations for  each  of  the  bureaus  in  the  different  departments  of  the  Govern- 
ment for  the  service  of  the  next  fiscal  year. 

42.  A  blank  estimate  form  is  provided  which  is  filled  out  by  the  several 
bureaus  before  submitting  their  annual  estimates  for  the  consideration  of  the 
heads  of  their  respective  departments. 

43.  Estimates  for  salaries  or  compensation  are  always  specified  and  are  never 
combined  with  the  estimates  for  general  or  contingent  expenses,  nor  are  con- 
tingent or  general  estimates  items  for  salaries  or  compensation. 

44.  All  estimates  for  contingent  and  general  expenses  pertaining  to  tlie 
bureau  are  included  in  the  naval  appropriation  bill.  Estimates  for  the  salaries 
of  all  civil  employees  in  the  bureau  are  included  in  the  legislative,  executive, 
and  judicial  appropriation  bill. 

45.  Estimates  under  the  two  appropriation  bills  are  submitted  by  the  l)ureau 
on  separate  estimate  sheets. 

Section  5, — Laws  Relating  to  Appropriations. 

51.  Appropriations  for  Navy  controlled  by  Secretary;  for  each  bureau  to  be 
kept  separately.     Sec.  3G76,  R.  S. 

52.  Applications  of  moneys  appropriated.     Sec.  3678,  R.  S. 

53.  No  expenditures  beyond  appropriations.  Sec.  3679,  R.  S.,  amended  by 
act  of  February  27,  1906;  (I  16). 

.54.  Restrictions  on  contingent,  etc.,  appropriations.     Sec.  3682,  R.  S. 

55.  Drafts  for  War  and  Navy  Departments.     See.  3673.  R.  S. 

56.  Form  of  drawing  and  charging  warrants.     Sec.  3675,  R.  S. 

57.  Special  appropriations  available  for  two  years.    Sec.  3685,  R.  S. 

58.  Permanent  indefinite  appropriations.     Sec.  3689,  R.  S. 

59.  Expenditure  of  balances  of  appropriations.     Sec.  3690.  R.  S. 

60.  Disposal  of  balances  after  two  years.    Sec.  3691,  R.  S. 

61.  Unexpended  balances  to  be  covered  into  the  Treasury.  Act  June  20, 
1874 ;  June  14,  1878.  ^       .   .   t  ,     o, 

62.  Auditing  accounts  by  Auditor  for  the  Navy  Department.     Act  July  31, 

1894.  .  ,,       ,    . 

63.  Method  of  fixing  cost  of  work  uiuier  naval  appropriation.s.     Act  March  4, 

1911. 

Section  G. — Fixed  and  Specific  Titles  of  Appropriations. 

71.  The  annual  appropriations  included  in  the  naval  appropriation  bill  that 
pertain  to  the  lUireau  of  Medicine  and  Surgery  are  classified  under  the  follow- 
ing fixed  titles: 

(a)  Medical  Department. 

ib)   Contingent,  Bureau  of  Medicine  and  Surgery. 

(r)   Transportation  of  remains. 

72.  The  detailed  objects  of  exp'cndltures  under  the  fixed  titles  are  to  be  found 
In  each  annual  digest  of  appropriations  from  which  the  following  is  abstracted: 

Mediial  1  X'liartnient :  For  surgeons'  necessaries  for  vessels  in  conunlssion. 
navv  vards,   naval   stations,  Marine  Corps,  and   for  the  civil   establishment   at 


MANUAL  FOR   THE    MEDICAL  DEPARTMENT,  U.    S.    NAVY.  9 

the  several  naval  hospitals,  navy  yards,  naval  luedical  supply  depots.  Naval 
Medical  School,  Washington,  and  Naval  Academy,  and  toward  the  accumula- 
tion of  a  reserve  supply  of  medical  stores. 

Contingent,  Bureau  of  Medicine  and  Surgery:  For  tolls  and  ferriages;  care, 
transportation,  and  burial  of  the  dead;  purchase  of  books  and  stationery, 
binding  of  medical  records,  unbound  books,  and  pamphlets ;  hygienic  and  sani- 
tary investigation  and  illustration;  sanitary  and  hygienic  instruction;  pur- 
chase and  repairs  of  nonpassenger-carrying  vragons,  automobile  ambulances, 
and  harness ;  purchase  of  and  feed  for  horses  and  cows ;  purchase,  maintenance, 
repair,  and  operation  of  two  passenger-carrying  motor  vehicles  for  naval  dis- 
pensary, Washington,  District  of  Columbia,  to  be  used  only  for  official  purposes ; 
trees,  plants,  care  of  grounds,  garden  tools,  and  seeds;  incidental  articles 
for  the  Naval  Medical  School  and  naval  dispensary,  Washington;  naval  medi- 
cal supply  depots,  sick  quarters  at  Naval  Academy  and  marine  barracks; 
washing  for  medical  department  at  Naval  Medical  School  and  naval  dispensary, 
Washington;  naval  medical  supply  depots,  sick  quarters  at  Naval  Academy 
and  marine  barracks,  dispensaries  at  navy  yards  and  naval  stations,  and  ships ; 
and  for  minor  repairs  on  buildings  and  grounds  of  the  United  States  Naval 
Medical  School  and  naval  medical  supply  depots;  rent  of  rooms  for  naval 
dispensary,  Washington,  District  of  Columbia,  for  the  care,  maintenance,  and 
treatment  of  the  insane  of  the  Navy  and  Marine  Corps  on  the  Pacific  coast, 
including  supernumeraries  held  for  transfer  to  St.  Elizabeths  Hospital  for 
the  Insane;  for  dental  outfits  and  dental  material  and  all  other  necessary 
contingent  expenses. 

Transportation  of  remains:  To  enable  the  Secretary  of  the  Navy,  in  his 
discretion,  to  cause  to  be  transferred  to  their  homes  the  remains  of  officers 
and  enlisted  men  of  the  Navy  and  Marine  Corps,  of -members  of  the  Nurse 
Corps,  and  of  officers  and  enlisted  men  of  the  Naval  Militia  and  National  Naval 
Volunteers  and  the  Naval  Reserve  Force  when  on  active  service  with  the 
Navy,  who  die  or  are  killed  in  action  ashore  or  afloat,  and  also  to  enable 
the  Secretary  of  the  Navy,  in  his  discretion,  to  cause  to  be  transported  to  their 
homes  the  remains  of  civilian  employees  who  die  outside  of  the  continental 
limits  of  the  United  States:  Provided,  That  no  deduction  shall  hereafter  be 
made  from  the  six  months'  gratuity  pay  allowed  under  the  naval  act  of  August 
twenty-second,  nineteen  hundred  and  twelve,  on  account  of  expenses  for  funeral, 
interment,  or  for  expenses  of  preparation  and  transportation  of  the  remains: 
Provided  further.  That  the  sura  herein  appropriated  shall  be  available  for 
paymeut  for  transportation  of  the  remains  of  officers  and  men  who  have 
died  while  on  duty  at  any  time  since  April  twenty-first,  eighteen  hundred  and 
ninety-eight,  and  shall  be  available  until  June  thirtieth,  nineteen  hundred 
and  eighteen. 

73.  Special  diet  as  "surgeons'  necessaries,"  is  a  charge  against  "Medical 
Department."  Quarantine  expenses  are  not  a  charge  against  the  appropriations 
for  the  Bureau  of  Medicine  and  Surgery,  but  are  charged  to  the  appropriation 
"  Pay,  miscellaneous,"  or  "  Contingent,  Marine  Corps,"  as  the  circumstances 
require.  Care  of  sick  in  hospital  is  a  charge  against  "  Naval  hospital  fund." 
Transportation  of  sick  and  insane  patients  is  a  charge  against  the  Bureau 
of  Navigation  or  the  Marine  Corps  as  the  case  may  be. 

74.  In  addition  to  the  fixed  titles,  the  Bureau  of  Medicine  and  Surgery, 
whenever  the  exigencies  of  the  service  require  such  action,  submits  through  the 
Bureau  of  Yards  and  Docks  with  its  annual  estimates  specific  titles  for  dis- 
bursements coming  under  its  cognizance,  such  as  contruction  of  hospitals,  naval 
medical  supply  depots,  quarters  for  officers,  and  all  other  expenditures  for 
which  the  fixed  titles  are  not  available  and  which  can  not  be  undertaken  with- 
out being  authorized  by  a  special  enactment. 

75.  The  naval  hospital  fund  is  available  for  the  maintenance  of  the  naval 
hosnitals  at  the  various  navy  yards  and  stations  and  for  care  and  maintenance 
of  patients  in  other  hospitals  at  home  and  abroad.     (See  chapter  22.) 


CHAPTER  2. 


THE  MEDICAL  COlli'S   AND   THE   NAVAL   RESERVE   FORCE. 

Section  1. — Laws  Relating  to  the  Organization  of  the  Medical  Corps. 

101.  Medical  Corps,  number  of.  Sec.  1368,  R.  S. ;  acts  Aug.  5,  1882,  June  7, 
1900.  IMar.  3,  1903,  Aug.  29,  1916. 

102.  Rank  and  title  of  medical  officers.  Sec.  1474,  R.  S. ;  acts  Mar.  3,  1899, 
Mar.  3,  1903,  Aug.  29,  1916. 

103.  Retired  for  age  or  length  of  service,  rank.  Sec.  1481,  R.  S. ;  acts  of 
Mar.  3,  1899,  May  13,  1908. 

104.  When  retired  for  causes  incident  to  service.  Sec.  1482,  R.  S. ;  act  Mar. 
3,  1899. 

Section  2. — Laws  Relating  to  Appointments. 

"111.  Appointments  in,  how  made.    Sec.  1369,  R.  S. 

112.  Citizenship.    Sec.  1428,  R.  S. 

113.  Assistant  surgeons,  examination,  age,  etc.  Sec.  1370,  R.  S.,  amended  by 
act  of  May  4,  1898. 

114.  Assistant  surgeons  from  date  of  original  appointment  take  rank  and 
precedence  with  lieutenants  (junior  grade).    Act  Aug.  29,  1916. 

115.  Acting  assistant  surgeons.    Sec.  1411,  R.  S. :  act  Feb.  15,  1879. 

116.  Acting  assistant  surgeons,  temporary  service.    Act  May  4,  1898. 

Section  3. — ^Navy  Regulations  Relating  to  Appointments. 

121.  Examining  boards,  R  331. 

122.  Composition  of  boards.    R  332. 

123.  Appointments  subject  to  examination.     R  3301. 

124.  Candidates  for  assistant  surgeon.     R  3305. 

125.  Forfeiture  for  nonappearance.     R  3319. 

126.  Penalty  for  false  certificate.    R  3320. 

127.  Acceptance  and  oath  of  office.    R  3321. 

128.  Expenses  of  candidates.    R  4540. 

Section  4. — General  Instbuctions  Relating  to  Professional  Examinations 
FOR  Appointment  as  Assistant  Surgeon. 

131.  A  candidate  for  appointment  in  the  Medical  Corps  of  the  Navy  is  first 
examined  for  enrollment  in  the  provisional  grade  of  assistant  surgeon,  rank  of 
lieutenant  (junior  grade).  United  States  Naval  Reserve  Force.  If  found  quali- 
fied, he  is  subsequently  assigned  to  duty  at  the  Naval  Meilical  School  for  a 
course  of  instruction  and  training,  during  which  he  receives  the  pay  and  allow- 
ances of  an  assistant  surgeon  of  the  Navy.  After  completing  the  course  at  the 
Naval  Medical  School  he  is  given  a  final  examination,  and  if  found  qualified  is 
recommended  for  commission  as  assistant  surgeon  in  the  Medical  Corps  of  the 
Navy.    Legislation  establishing  the  United  States  Naval  Reserve  Force  contains 

11 


12  MANUAL   FOR    THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

In  substance  matter  referable  to  commissioned  grades  in  the  Medical  Corps  as 
follows : 

(c)  A  member  must  be  a  citizen  of  the  United  States,  except  the  Naval 
Auxiliary  Reserve. 

(6)  A  member  obligates  himself,  and  may  be  ordered  to  serve  in  the  Navy 
throughout  a  war  or  during  the  existence  of  a  national  emergency  declared  by 
the  President  should  either  arise  during  his  term  of  enrollment. 

(c)  A  member  enrolls  or  reenrolls  for  a  term  of  four  years. 

(d)  In  time  of  peace,  and  when  no  national  emergency  exists,  a  member  may 
be  discharged  upon  his  own  request  upon  reimbursing  the  Government  for  any 
clothing  gratuity  that  may  have  been  furnished  during  his  current  enrollment. 

(e)  A  member  is  required  to  take  the  oath  of  allegiance  to  the  United  States. 
(/)  A  member  is  given  a  provisional  grade   (assistant  surgeon)   upon  first 

enrollment  in  accordance  with  his  qualifications  determined  by  examination. 

(g)  A  member  after  enrolling  may,  in  time  of  peace,  upon  his  own  request,  be 
assigned  active  duty  in  the  Navy  for  such  periods  of  instruction  and  training  as 
may  enable  him  to  qualify  for  and  be  confirmed  in  grade. 

(h)  For  confirmation  in  grade  a  member  must  serve  the  minimum  amount  of 
active  service  required  (three  months)  and  must  qualify  by  examination  under 
regulations  prescribed  by  the  Secretary  of  the  Navy. 

(t)  The  minimum  active  service  required  for  maintaining  the  efficiency  of  a 
member  (Naval  Coast  Defense  Reserve)  is  three  months  during  each  term  of 
enrollment.  This  active  service  may  be  in  one  period  or  in  periods  of  noi  less 
than  three  weeks  each  year. 

(;■)  No  person  shall  be  appointed  or  commissioned  an  officer  in  any  rank  in 
any  class  of  the  United  States  Naval  Reserve  Force,  or  promoted  to  a  higher 
rank  therein,  unless  he  shall  have  been  examined  and  recommended  for  such 
appointment,  commission,  or  promotion  by  a  board  of  three  naval  officers  not 
below  the  rank  of  lieutenant  commander,  nor  until  he  shall  have  been  found 
pliysically  qualified  by  a  board  of  medical  officers  to  perform  the  duties  required 
in  time  of  war,  except  that  former  officers  and  midshipmen  of  the  Navy  who 
shall  have  left  the  service  under  honorable  conditions  and  who  shall  have  en- 
rolled in  the  United  States  Naval  Reserve  Force  may  be  appointed  in  the  grade 
and  rank  last  held  by  them  without  examination  other  than  the  physical  exami- 
nations herein  prescribed.  ,,    ,   - 

(fc)  A  member  receives  retainer  pay  of  $12  per  annum  while  enrolled  in  a 
provisional  grade,  provided  he  makes  such  reports  concerning  his  movomenta 
and  occupation  as  may  be  required  by  the  Secretary  of  the  Navy.  After  con- 
firmation in  grade  his  annual  retainer  pay  is  two  months'  base  pay  of  the  cor- 
responding rank  in  the  Naw.  Retainer  pay  is  in  addition  to  any  pay  to  which 
a  member  may  be  entitled  by  reason  of  active  service.  Members  of  the  Volun- 
teer Naval  Reserve  do  not  receive  any  retainer  pay.  ^,       , 

(I)  A  member  who  reenrolls  for  a  term  of  four  years,  within  four  months  of 
expiration  of  last  complete  enrollment,  and  who  has  performed  the  minimum 
amount  of  active  service  required  during  the  preceding  term  of  enrollment,  for 
each  reonrollment  receives  an  increase  of  25  per  cent  of  his  base  retainer  pay. 
A  member  wlio  completes  20  years  of  service,  and  who  has  performed  the  mini- 
mum auK.unt  of  active  service  each  term  of  enrollment,  on  his  own  application 
will  be  retired  with  rank  held,  with  a  cash  gratuity  equal  to  the  total  amount 
of  his  retainer  pay  during  his  last  term  of  enrollment. 

(m)  A  member  may  accept  employment  in  any  branch  of  the  public  service 
exf-ept  as  an  officer  or  enlisted  man  in  any  branch  of  the  military  service  ot  the 
Uiiite<l  States  or  any  State  thereof. 

(71)  A  member  Is  subject  to  the  laws,  regulations,  and  orders  for  the  govern- 
ment of  the  Regular  Naw  only  during  such  time  as  he  may  liy  law  be  required 
to  serve  In  the  Naw  in  accordance  with  his  obligation,  and  when  on  active  scm-v- 
Ice  at  his  own  request,  and  when  employed  in  authorized  travel  to  and  from 
such  active  service  In  the  Navy. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.  13 

(o)  A  distinctive  badge  or  button  will  be  issued  to  be  worn  only  by  members 
of  the  United  States  Naval  Reserve  Force.  A  penalty  is  assigned  for  unau- 
thorized use  of  this  emblem. 

(p)  A  member  actively  employed  receives  the  same  pay  and  allowances,  gra- 
tuities, and  other  emoluments  as  an  officer  of  the  naval  service  on  active  duty 
of  corresponding  rank  and  of  the  same  length  of  service.  When  not  actively 
employed  a  member  is  not  entitled  to  pay,  bounty,  gratuity,  or  pension,  except 
as  expressly  provided  by  the  provisions  of  the  act. 

(g)  When  first  reporting  for  active  service  for  training  during  each  period  of 
enrollment,  officers  are  credited  with  a  uniform  gratuity  of  $50,  except  the  Vol- 
unteer Naval  Reserve.  In  time  of  war  or  national  emergency  they  are  credited 
with  $150,  less  the  amount  previously  credited,  if  any,  during  the  current 
enrollment. 

(r)  The  various  grades  not  above  lieutenant  commander  in  rank  correspond- 
ing to  those  in  the  Navy  are  allowed.  Officers  in  the  United  States  Naval  Re- 
serve Force  rank  with,  but  after,  officers  of  corresponding  rank  in  the  Navy. 
Officers  are  commissioned  by  the  President. 

132.  (a)  Enrollment  in  the  United  States  Naval  Reserve  Force,  with  a  view 
to  subsequent  appointment  in  the  Medical  Corps  of  the  United  States  Navy, 
shall  be  made  in  the  Naval  Coast  Defense  Reserve,  class  4,  United  States  Naval 
Reserve  Force;  or,  Volunteer  Naval  Reserve  for  duty  in  the  Naval  Coast 
Defense  Reserve,  class  4,  United  States  Naval  Reserve  Force.  (Members  of 
the  Volunteer  Naval  Reserve  receive  no  retainer  pay  or  uniform  gratuity  in 
time  of  peace,  but  when  on  active  duty  they  receive  the  pay  of  their  grade  and 
service. ) 

(b)  A  candidate  for  appointment  in  the  Medical  Corps  of  the  United  States 
Navy  must  be  a  citizen  of  the  United  States,  between  21  and  32  years  of  age, 
and  a  graduate  of  a  reputable  school  of  medicine. 

(c)  The  application  must  be  in  the  handwriting  of  the  applicant  and  accord- 
ing to  the  following  form: 

(Residence.) 

,  19__. 

Sib:  I  request  permission  to  be  examined  for  enrollment  in  the  provisional 
grade  of  assistant  surgeon,  rank  of  lieutenant  (junior  grade),  in  the  Naval  Coast 
Defense  Reserve,  class  4,  United  States  Naval  Reserve  Force,  with  a  view  to 
subsequent  examination  for  appointment  in  the  Medical  Corps  of  the  United 
States  Navy.' 

I  was  born  at ,  and  was years  of  age  on  the 

<^ay  of ,  19_--;  and  am  a  citizen  of  the  United  States,  residing 

in ,  county  of ,  in  the  State  of , 

and  graduated  from I Medical  School  in  19__. 

I  forward  herewith  letters  testifying  to  my  moral  character,  habits,  citizen- 
ship, preliminary  education,  and  professional  qualifications. 
Very  respectfully, 

(Name  In  fulf,  written  legibly.) 
Chief  of  the  Bureau  of  Medicine  and  Subgery, 

Navy  Department,  Washington,  D.  C. 

(d)  The  above  application  must  be  accompanied  by  the  following  certificates: 
(c)  Letters  or  certificates  from  two  or  more  persons  of  good  repute,  testi- 
fying from  personal  knowledge  to  good  habits  and  moral  character. 

'  ( 6 )  A  certificate  or  statement  from  some  person  of  good  repute  that  the 
applicant  is  a  citizen  of  the  United  States.  In  case  the  applicant  is  a 
naturalized  citizen  of  the  United  States,  his  naturalization  papers,  or  other 
satisfactory  evidence  of  citizenship,  must  be  submitted. 


1  When  directed    the  applicant  should  substitute  the  words  "  Volunteer  Naval  Reserve 
for  duty  in  the  Naval  Coast  Defense  Reserve,  class  4,  United  States  Naval  Reserve  Force 
for  the  words  "  Naval  Coast  Defense  Reserve,  class  4,  United  States  Naval  Reserve  Force. 


14  MANUAL  FOR   THE   MEDICAL  DEPARTMENT,   U.    S,    NAVY. 

(c)  Certificate  of  preliminary  education:  The  candidate  must  submit  a 
certificate  of  {?i-aduation  from  an  accepted  liigh  school  or  an  acieptable 
equivalent. 

(d)  Certificate  of  medical  education:  This  certificate  should  give  the 
name  of  the  school  and  the  date  of  graduation. 

(e)  If  the  candidate  has  had  hospital  service  or  special  educational  or  pro- 
fessional advantages,  certificate  to  this  effect,  signed  by  the  proper  authorities, 
should  also  be  forwarded. 

(/)  The  applicant  will  save  unnecessary  correspondence  if  he  will  make  sure 
when  submitting  his  application  that  the  qualifications  enumerated  above  are 
clearly  and  plainly  described  in  his  letters  or  certificates. 

133.  After  passing  upon  the  credentials  of  the  candidate  the  Bureau  of 
Medicine  and  Surgery  will  issue  a  permit  to  the  candidate  to  appear  for  pro- 
visional physical  and  professional  examination  before  one  or  more  medical 
examiners  designated  by  the  Bureau  of  Medicine  and  Surgery  via  the  com- 
mandant or  commanding  ofllcer.  The  permit  is  effective  for  a  stated  period,  antl 
directs  the  candidate  to  communicate  with  the  senior  medical  examiner,  who 
informs  the  candidate  of  the  date  and  local  place  of  examination.  An  effort 
will  be  made  to  select  a  place  for  the  examination  as  near  as  possible  to  the 
place  of  residence  of  the  candidate. 

Medical  examiners  to  conduct  the  provisional  examination  are  usually  in  ses- 
sion frequently  at  the  following  naval  stations: 

Washington,  D.  C.  Great  Lakes  (North  Chicago),  111. 

Boston,  Mass.  Mare  Island,  Cal. 

New  York,  N.  Y.  Puget  Sound,  Wash. 

Philadelphia,  Pa.  Fort  Lyon.  Colo. 

Norfolk,  Va.  Portsmouth,  N.  H. 
Charleston,  S.  C. 

134.  After  examination  a  successful  candidate  is  enrolled  in  the  provisional 
grade  of  assistant  surgeon,  rank  of  lieutenant  (junior  grade),  in  the  United 
States  Naval  Reserve  Force,  and  afterwai-ds  attends  a  course  of  instruction  and 
training  at  the  Naval  Medical  School,  Washington,  D.  C.  A  course  begins 
annually  about  September  1,  and  lasts  about  four  months.  A  second  session 
usually '  begins  in  January  and  lasts  until  late  in  May.  After  receiving  his 
certificate  of  enrollment  and  taking  the  oath  of  allegiance,  the  newly  enrolled 
officer  should  forward  through  his  commanding  ofTuer  his  request  for  active 
duty  in  attendance  at  the  Naval  Medical  School  for  a  course  of  instruction  and 
training. 

135.  The  entrance  examination  for  the  Medical  Corps  thus  consists  of  two 
parts — the  preliminary,  prior  to  appointment  in  the  Naval  Reserve  Force,  and 
the  final,  after  assignment  to  duty  at  the  Naval  Medical  School. 

136.  Members  of  each  class,  upon  graduating  from  the  Naval  Medical  School, 
will  be  commissioned  in  the  order  of  merit  as  determined  upon  final  examina- 
tion, but  not  in  excess  of  the  number  of  vacancies  in  the  Medical  Corps. 

137.  Since  no  officer  can  be  conuuissioned  in  the  Medical  Corps  who  is  over 
32  years  of  age,  permits  will  not  be  issued  to  applicants  who  can  not  complete 
the  prescribed  course  at  the  Naval  Medical  School  and  obtain  their  appointment 
while  within  the  age  limit. 

138.  When  a  candidate  presents  himself  for  examination  he  must  bring  with 
him  the  testimonials  as  to  character  and  professional  fitness,  diplomas  and 
other  certificates,  and  certificate  or  statement  that  he  is  a  citizen  of  the  United 
States,  those  forwarded  with  his  application  having  been  returned  to  him  for 
this  purpose. 

131).  (a)  The  physical  examination  is  thorough  and  the  candidate  is  required 
to  certify  that  lie  is  free  from  all  mental,  physical,  and  constitutional  defects. 

(b)  Acuteiioss  of  vision,  12/20  for  each  eye.  unaided  by  glasses,  but  capable 
of  correction  by  aid  of  lenses  to  20/20,  Is  obligatory.  Color  perception  must  be 
normal  and  the  teeth  good. 


MANUAL  FOR   THE   MEDICAL   DEPARTMEN^T,   U.    S.    NAVY.  15 

(c)  If  the  candidate  is  found  to  be  physically  disqualified,  his  examination 
is  concluded,  but  in  the  case  of  a  candidate  otherwise  desirable  the  medical 
examiners  may  recommend  that  minor  disqualifications  or  departures  from 
standard  be  waived  and  proceed  with  the  professional  examination,  subject 
to  final  approval  by  the  department;  if  found  to  be  physically  qualified,  his 
examination  is  continued  as  follows: 

110.  Professional  examination.— (a)  Letter  to  the  medical  examiners,  giving 
a  brief  statement  of  the  candidate's  general  and  professional  education. 

(6)  Written  examination  (a)  anatomy,  (b)  physiology,  (c)  materia  medica 
and  therapeutics,  (d)  general  medicine,  (e)  general  surgery,  and  (/)  obstetrics. 
Two  or  more  questions  are  asked  in  each  subject. 

(c)  An  oral  examination  is  conducted  in  each  of  the  above  enumerated  sub- 
jects. 

(d)  The  medical  examiners  will  give  careful  consideration  to  composition 
and  spelling  as  shown  in  the  written  papers  submitted  by  the  candidates, 

(e)  Seventy-five  per  cent  is  required  as  a  general  average. 

With  the  consent  of  the  medical  examiners  a  candidate  may  withdraw  at 
any  time  from  further  examination  and  may  at  a  future  time  present  himself 
for  reexamination,  provided  such  examination  is  not  delayed  until  after  the  date 
that  his  permit  would  expire. 

141.  (a)  A  candidate  failing  in  the  provisional  examination  with  a  view  to 
subsequent  appointment  in  the  Medical  Corps  of  the  United  States  Navy  may  be 
found  qualified  for  provisional  enrollment  (not  with  a  view  to  subsequent  ap- 
pointment in  the  Medical  Corps  of  the  United  States  Navy),  or  may  apply  for  a 
reexamination,  but  such  reexamination  will  not  be  granted  until  after  a  period 
of  six  months  has  elapsed  since  the  last  examination. 

(&)  No  allowance  will  be  made  for  the  expense  of  candidates  appearing  for 
examination. 

(c)  If  the  medical  examiners  find  the  candidate  duly  qualified  physically  and 
professionally  for  enrollment  in  the  provisional  grade  of  assistant  surgeon,  rank 
of  lieutenant  (junior  grade),  Naval  Coast  Defense  Reserve,  class  4,  United 
States  Naval  Reserve  Force,  with  a  view  to  subsequent  appointment  in  the 
Medical  Corps  of  the  United  States  Navy ;  or.  Volunteer  Naval  Reserve  for  duty 
in  the  Naval  Coast  Defense  Reserve,  class  4,  United  States  Naval  Reserve 
Force,  with  a  view  to  subsequent  appointment  in  the  Medical  Corps  of  the 
United  States  Navy,  it  will  immediately  forward  a  report  and  recommendation 
to  this  effect  direct  to  the  Bureau  of  Medicine  and  Surgery,  together  with  the 
certificate  of  the  candidate  as  to  his  physical  condition,  the  personal  and  physi- 
cal data  form,  the  examination  papers  of  the  candidate,  and  the  letter  of  the 
candidate  to  the  medical  examiners.  A  report  and  recommendation  will  also  be 
made  when  a  candidate  is  found  not  qualified. 

(d)  After  approval  of  the  record  of  examination  and  the  recommendation  of 
the  medical  examiners  in  the  case  of  a  qualified  candidate,  the  Bureau  of  Medi- 
cine and  Surgery  will  recommend  to  the  Bureau  of  Navigation  the  provisional 
enrollment  of  the  candidate  in  the  United  States  Naval  Reserve  Force. 

(c)  A  member  of  the  United  States  Naval  Reserve  Force  may  transfer  to  or 
from  the  Volunteer  Naval  Reserve  upon  approval  by  the  Bureau  of  Navigation 
of  his  request  to  this  effect. 

142.  Final  examination  (Naval  Medical  School). —  (a)  The  final  physical 
examination  is  thorough  in  character.  No  person  will  receive  an  appointment 
whose  physical  condition  may  indicate  the  possibility  of  early  retirement  for 
disability. 

(&)  The  professional  examination  will  be  on  the  subjects  embraced  in  the 
course  of  instruction,  such  as  naval  and  general  hygiene,  naval  and  operative 
surgery,  tropical  medicine  and  pathology,  medical  zoology,  practical  chemistry, 
bacteriology  and  serology,  ophthalmology,  Naval  Regulations,  Hospital  Corps 
drills,  and  duties  of  the  medical  oflicer  afloat  and  ashore. 

(c)  During  the  course  of  instruction  the  character,  habits,  and  general  de- 
portment of  student  officers  are  closely  observed.     If  it  appears  during  a  candi- 


16  MANUAL  FOR   THE   MEDICAL  DEPAETMENT^  U.    S.    NAVY. 

date's  attendance  at  the  school  that  his  appointment  in  the  Medical  Corps  would 
be  undesirable,  he  will  be  relieved  from  active  duty  and  his  discharge  from  the 
Kaval  Reserve  Force  recommended. 

143.  The  board  for  the  final  examination  is  required  under  oath  to  report  on 
the  physical,  mental,  moral,  and  professional  qualifications  of  the  candidate. 

144.  A  successful  candidate  upon  completion  of  his  school  examination  will 
be  notified  of  the  result  by  the  president  of  the  board. 

145.  A  candidate  who  at  the  final  examination  is  found  not  fully  qualified 
professionally,  but  physically,  mentally,  and  morally  qualified,  may  apply  for 
active  service  (at  sea)  with  a  view  to  enabling  him  further  to  establish  his 
qualifications  for  confirmation  in  grade  as  assistant  surgeon.  United  States 
Naval  Reserve  Force.  After  performing  the  additional  amount  of  active  service 
thus  required  (at  sea),  he  will  be  examined  physically  and  professionally  befoi'e 
a  statutory  board.  The  professional  examination  may  be  limited  to  his  service 
record  if  the  board  is  satisfied  that  the  candidate  is  qualified  to  perform  his 
duties  as  a  member  of  the  United  States  Naval  Reserve  Force. 

146.  No  candidate  will  be  given  the  course  at  the  Naval  Medical  School  more 
than  once. 

147.  A  candidate  who  is  provisionally  enrolled  in  the  United  States  Naval 
Reserve  Force  with  a  view  to  subsequent  appointment  in  the  Medical  Corps  oC 
the  Navy,  before  the  course  of  instruction  at  the  Naval  Medical  School  begins, 
may  upon  application  be  assigned  to  active  duty  at  some  shore  station  with  full 
pay  and  allowances  pending  his  detail  to  the  Naval  Medical  School,  should  his 
instruction  be  considered  desirable. 

Section  5. — Navy  Regxtlations  and  Naval  Instructions  Relating  to  Exami- 
nations FOR  Appointment  as  Acting  Assistant  Surgeon.  (See  R  3305  (2).) 
(Sec.  1411,  R.  S. ;  act  of  May  4,  1898.) 

151.  The  physical  and  professional  examination  of  candidates  for  appoint- 
ment as  acting  assistant  surgeons  shall  conform  in  general  to  that  prescribed  in 
the  regulations  and  instructions  relating  to  the  examination  of  candidates  for 
appointment  as  assistant  surgeons.  Naval  Reserve  Force. 

152.  Service  dress  and  white  service  dress  uniforms  only  are  required  for 
acting  assistant  surgeons.  (See  Uniform  Regulations,  U.  S.  Navy,  1913,  par. 
6  (c).) 

Section  6. — Laws  Relating  to  Promotion. 

161.  Rank  of  assistant  surgeon  in  case  of  delayed  examination.  Sec.  1372, 
R.  S. 

162.  Passed  assistant  surgeon,  promotion  on  examination.  Act  of  Feb.  13, 
1897. 

168.  Appointment  of  surgeons.     Sec.  1371,  R.  S. ;  act  Feb.  13,  1897. 

164.  Physical  and  professional  examination  for  promotion.  Sees.  1493-1510, 
R.  S. ;  acts  June  18,  1878,  Aug.  5,  1882. 

165.  An  officer  failing  to  pass  the  physical  examination  for  promotion  shall 
be  retired  with  the  rank  to  which  his  seniority  entitles  him.     Act  IM:ir.  4,  1911. 

166.  An  officer  failing  to  pass  professionally  in  an  examination  for  promotion 
is  suspended  from  promotion  for  at  least  six  montlis  and  loses  ninnbers  equal  to 
the  average  six  months'  rate  of  promotions  for  the  preceding  five  fiscal  years. 
R.  S.  1505 ;  act  of  Mar.  11,  1912. 

167.  Officers  of  the  lower  grades  are  advanced  in  rank  up  to  and  Including 
the  rank  of  lieutenant  commander  with  the  officers  of  the  line  with  whom  or 
next  after  whom  they  take  precedence.     (Act  of  Aug.  29,  1916.) 

168.  All  laws  relating  to  the  examination  of  officers  of  the  Navy  for  promo- 
tion apply  to  the  regular  advancement  of  .staff  officers  to  higher  ranks  on  the 
active  list,  tiie  same  as  though  such  a<lvancements  in  rank  were  promotions  to 
higher  grades.     (Act  of  Mar.  4,  1917.) 


MANUAL   FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.  17 

160.  Section  20.  act  approved  May  22,  1917,  provides  "  That  hereafter  all  laws 
relating  to  the  examination  of  officers  of  the  Navy  for  promotion  shall  ho  con- 
strued to  apply  to  the  regular  advancement  of  staff  officers  to  higher  ranks  on 
the  active  list  the  same  as  though  such  advancements  in  rank  were  promotions 
to  higher  grades:  Provided,  That  examinations  for  such  staff  officers  shall  not 
be  required  except  for  such  regular  advancements  in  rank:  Provided  further, 
That  the  President  be,  and  he  is  hereby,  authorized  to  direct  the  Secretary  of 
the  Navy  to  take  such  action  on  the  records  of  proceedings  of  naval  examining 
boards  and  boards  of  naval  surgeons  for  the  promotion  of  officers  of  the  Navy 
as  is  now  required  by  law  to  be  taken  by  the  President." 

Si;c'tion   7. — Navy  Regulations  and  Navai,  Instkuctions  Relating  ^  Peo- 

motions.  ;  j!",!-! !(?,"/ 

171.  Convening  of  board.    R  331  (1). 

172.  Physical  examination  precedes  professional.    R  331  (2). 
17.?.  Procedure  upon  finding  physical  disabilities.    R  331  (3-4). 

174.  Composition  of  boards.     R  332.  ' 

175.  Organization  and  procedure;     R  334. 

176.  Onus  of  establishing  fitness.     R  334  (10). 

177.  Eligibility  for  promotion.    R  3331. 

178.  Examinations  on  foreign  stations.     R  3333. 

179.  Reports  of  fitness.    I  707. 

1 80.  Health  record  on  prottiOtioti.    t  3257 ;  I  70S. 

Section   8. — Instructions  Relating  to   the  Professional  Examination   for 
'  Promotion    of   Assistant   Surgeons   to   the   Grade   of   Passed   Assistant 
Surgeon.  '    '■'■"'',''-'■'■"        '    • 

''191.  Officers  undergoing  exami'riatlori'^WW'tTi^' grafle 'fi¥' assistant  .surgeon 
are  not  examined  orally  except  in  explanation  of  written  and  practical  work. 

192.  The  written  examination  shall  embrace  the  following  subjects : 

(a)  Letter  to  the  board,  giving  an  account  of  general  and  professional  duties 
.since  admission  to  the  service.  . 

(6)  Examinations  in  the  following  subjects,  the  order  of  which  may  be 
Varied  at  the  discretion  of  the  board:  Anatomy  (regional  and  surgical),  phy- 
siology, pathology,  materia  medica  and  therapeutics,  general  medicine,  general 
surgery,  obstetrics,  general  and  naval  hygiene.  Navy  regulations,  naval  instruc- 
tions, and  Manual  for  the  Medical  Department,  United  States  Navy. 

193.  Assistant  surgeons  are  also  examined  in  the  following  subjects: 
Practical  operative  surgery. 

Clinical  medicine  (cases  in  wards  and  recording  clinical  ca,ses  in  meiUcal 
records).  ,,  .       :  , 

Practical  work  in  laboratory,  including. cjiemistry,  bacteriology,,  hj^giene^  .inedi- 
cine,  and  pathology.  ,,  ,      '.:  ,,    :, 

,'    Bandaging  and  the  application  of  splints.      .  '    ,        , 
[.  :pecognition  of  surgical  instruments  and  appliances. 

Section  9.— Instri^ctioks  Relating  to  the  Professional  ExAMiNATroN  of 
Passed  Assistant  Surgeons  for  Promotion  to  Grade  of  Surgeoj:^.  .  (See 
also  paragraph  168.)  ^  ^  fH-isnnu'ni 

201.  In  the  promotion  of  medical  oflficers  from'  the  grade  of  passed  assistant 
surgeon  to  surgeon,  written  examinations  are  required  on  the  following  sub- 
jects, the  order  of  which  may  be  varied  at  the  discretion  of  .the  boprd:,.^   ,^  .^  _.^^ 
General  and  navnl  hygiene.  ^  .V,  ,.,  ..  i'l'..  .iX' 

Clinical    medicine,    including    recent   progress    in    et|ol6g^,;  pa^hplofeyj^'^'d^ 

.therapeutics.  .■yuiUi'u  'lu  ••!;<( '''"^'in^"  "<';' 


18  MANUAL  FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

Military  surgery,  Inrludins  new  operative  procedures,  and  familiarity  with 
the  technique  of  aseptic  surgery. 

Navy  Urgulations  and  Naval  Instructions,  so  far  as  they  relate  to  the 
Mcidical  Department  or  to  tlie  medical  officer  as  an  officer  of  the  Navy  and  the 
Manual  for  the  Medical  Department. 

,202.  Passed  assistant  surgeons  on  promotion  are  also  examined  practically 
op  tbe  same  subjects  as  assistq at; surgeons  for  promotion.  .  (See  par.  193.) 

Section  10.— Instructions  Relating  to  the  Professional  Examination  or 

SUKGEONS  fob   PROMOTION. 

211.  In  the  promotion  of  medical  officers  from  the  grade  of  .surgeon  to 
medical  inspector  the  professional  examination  shall  comprise  the  following 
subjects : 

Duties  of  fleet  surgeon,  including  the  inspection  of  ships  and  ho.spitals  and 
the  sanitation  of  fleet,  barracks,  and  camps. 

Administration  and  fitting  out  of  hospitals  and  hospital  ships. 

Hospital  plans  and  construction. 

Duties  at  supply  depots,  including  the  purchase,  transportation,  distribution, 
and  i.'^sue  of  medical  supplies. 

A  medico-naval  problem.  Example:  Organization  of  Medical  Department  of 
the  fleet  during  war,  including  organization  of  ambulance  parties  of  the  land- 
ing force.  The  use  of  a  library  for  reference  will  be  permitted  and  adequate 
time  allowed  for  a  satisfactory  solution  of  any  problem  submitted  to  the 
candidate.  ' 

Section   11. — Instructions  Relating  to  the  Professional  Examination  ■  of 
Meoical  Inspectors  for  Promotion. 

221.  In  the  promotion  of  medical  officers  from  the  grade  of  medical  inspector 
to  medical  director,  the  professional  examination  shall  be  based  upon : 

Record  of  the  officer  undergoing  examination. 

Thesis  on  some  professional  subject  which  has  been  a  matter  of  study  or 
observation  by  him  since  his  last  examination. 

Examination  on  such  additional  subjects  as  may  be  deemed  advisable  by  the 
board  in  the  case  of  any  medical  inspector,  should  such  procedure  be  considered 
necessary  in  order  definitely  to  determine  the  candidate's  qualifications  for  pro- 
motion. ,.   ,^.    ^..    ;_.,,_;; 

Section.  12.— jKSTByc5fiQNS  IIeij^tinqto 'the  "i^ aval  Reserve  Force.     (Act  of 
'       •        -' '   '   Aug.  29,  1916.) 

i 

231.  A  candidate  for  enrollment  as  a  meflical  officer  Is  first  exahilned  for 
enrollment  in  the  provisional  grade  of  assistant  surgeon,  rank  of  lieutenant 
(junior  grade).  United  States  Naval  Reserve  Force.  Afterwards,  if  his  enroll- 
iiumt  is  accomplished,  should  he  so  desire,  he  makes  request  for  active  duty 
for  confirmation  in  grade,  and  after  the  completion  of  a  minimum  period  of 
three  months'  active  service  (at  sea)  he  is  again  examined,  and  if  found  quali- 
fied is  recommended  for  a  cominissiou  as  an  assistant  surgeon,  United  States 
Naval  Reserve  Force. 

232.  Detailed  information  as  to  the  obligations,  emoluments,  and  necessary 
qiiiilificatinns  for  enrollment  in  general  will  be  found  in  paragraph  LSI  (ff-r). 

251.  (a)  Enrollment  of  persons  (not  previously  connected  with  the  Regular 
Navy),  except  enrollments  in  the  Naval  Auxiliary  Reserve,  cla.ss  o,  Unitetl 
States  Naval  Reserve  Force,  as  assistant  surgeons,  TTnit(>d  States  Naval  Reserve 
Force,  shall  be  made  in  tli(>  Naval  Coast  l>efense  Reserve,  class  4.  or  Volunteer 
Naval  Re.serve  for  duty  in  the  Naval  Coast  Defense  Reserve,  class  4,  United 
States  Naval  Ri-serve  Force.  (Members  of  the  Volunteer  Naval  Reserve  receive 
no  retain(!r  pay  or  uniform  gratuity  in  time  of  i)eace,  but  when  on  active  duty 
they  receive  the  service  pay  of  their  grade  and  service.) 


MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY.  19 

.  (b)  Citizens  of  the  United  States  or  of  its  insular  possessions  of  the  sea- 
going profession  who  shall  have  heen  or  may  be  employed  on  American  vessels 
of  the  merchant  marine  of  suitable  type  for  use  as  naval  auxiliaries,  and  which 
shuU  have  been  listed  as  sudi  by  the  Navy  Department  for  use  in  war,  shall  be 
eligible  for  membership  in  the  Naval  Auxiliary  Reserve  as  assistant  surgeons, 
subject  to  the  examinations  hereinafter  prescribed.  Their  annual  retainer  pay 
after  confirmation  is  one  month's  base  pay  of  the  corresponding  rank  in  the 
Navy. 

(c)  A  candidate  for  enrollment  as  above  must  be  between  21  and  44  years  of 
age  and  a  citizen  of  the  United  States,  except  as  noted  above  with  reference  to 
the  Naval  Auxiliary  Reserve.  He  must  be  a  gradimte  of  a  reputable  medical 
school,  legally  authorized  to  confer  the  degree  of  doctor  of  medicine. 

252.  Application  for  enrollment  must  be  made  in  the  handwriting  of  the 
applicant  accoi'ding  to  the  following  form: 

(n-.i^Yil  !    .1 , 

(Residence.) 

grf- ,  10— 

i''STR:  I  request  permission  to  be  examined  for  enrollment  in  the  provisional 
grade  of  assistant  surgeon,  rank  of  lieutenant,  junior  grade,  Naval  Coast  De- 
fense Reserve,  class  4,  United  States  Naval  Reserve  Force.* 

I  was  born  at ,  and  was years  of  age  on  the 

day  of— -L: — ,  191—;  graduated  from medical  school  in 

19_'_.  was  licensed  to  practice  medicine  in  the  State  of 

'  'I  am  a  citizen  of  the  United  States,  residing  in ,  county  of 

,  in  the  State  of 

I  forward  herewith  letters  testifying  to  my  moral  character,  haliits,  citizen- 
ship, preliminary  education,  medical  education,  society  membership,  license  to 
practice  medicine,  and  professional  qualifications. 
Very  respectfully, 

(Name  In  full»  written  legibly.) 

Chief  of  the  BtrEEAU  or  Medicine  and  StiROEUY, 

•  '■''       Navy  Department,  Washington,  D.  C. 

•^53.  The  above  application  must  be  accompanied  by  the  following  certificates: 
'■''{a)  Letters  or  certificates  from  two  or  more  persons  of  good  repute,  testify- 
ing from  personal  knowledge  to  gowl  habits  and  moral  character. 

(/))A  certificate  or  statement  from  some  person  of  good  repute  that  the 
applicant  is  a  citizen  of  the  United  States.  In  case  the  applicant  is  a  natural- 
ized citizen  of  the  United  States  his  mituralization  papers  or  other  satisfactory 
evidence  of  citizenship  must  be  submitted. 

•'  '(d)' Certificate  of  preliminary  education.  Tlie  candidate  must  submit  a  cer- 
tificate of  graduation  from  an  accepted  high  school  or  an  acceptable  equivalent. 
■■(■^)  Certificate  of  medical  education.  This  certificate  should  give  the  name 
of  the  school  and  the  date  of  graduation.  , 

'   Xe-y-A  certificate  from  the  president  or  secretary  of  a  State  or  local  medical 
society  to  the  effect  that  the  applicant  is  a  member  in  good  standing. 
vii(/)   A  certificate  of  license  to  practice  medicine. 

.rT^(7)  If  the  candidate  has  had  hospital  service  or  .special  educational  or  pro- 
fessional advantages,  certificates  to  this  effect,  signed  by  the  proper  authori- 
ties, should  also  be  forwarded. 

The  applicant  will  save  unnecessary  correspondence  if  he  will  make  sure 
when  submitting  bis  application  that  the  qualifications  enumerated  above  are 
clearly  and  plainly  described  in  his  letters  or  certificates. 

1  When  directed,  the  applicant  should  substitute  the  words  "  Volunteer  Naval  Reserve 
for  duty  in  the  Naval  Coast  Defense  Reserve,  <;lass  4,  United  States  Naval  Reserve  Force, 
for   the   words   "  Naval   Coast   Defense    Reserve,    class    4,    United    States   Naval    Reserve 
FurcG  ** 


20  MANUAL   FOR   TllE    MEWCAL   DEPARTMENT,   U.    S.    NAVY. 

254.  (a)  Aftor  pnssinp;  upon  the  cnvlcntinls  of  tho  candidate  tho  P.uroau 
of  Medicine  and  Sur;,'ery  will  issue  a  permit  to  the  candidate,  effective  for  a 
slated  period,  to  appear  before  one  or  m<<re  medical  examiners  designated  by  the 
bureau  via  the  commandant  or  commanding  officer  for  his  provisional  physical 
and  professional  examination.  Tlio  permit  will  din^t  the  candidate  to  com- 
municate with  tlie  senior  medical  examiner  as  to  the  date  and  place  of  examina- 
tion. An  effort  will  be  made  to  select  the  place  of  examination  as  near  as 
possible  to  the  phu'e  of  residence  of  the  candidate. 

(h)  When  a  candidate  presents  himself  for  examination  on  the  date  fixe<l 
by  the  senior  medical  examiner,  he  must  bring  with  him  the  testimonials  as 
to  character,  habits,  citizenship,  preliminary  education,  medical  eilucation,  mem- 
bi'rship  in  a  State  or  local  medical  .society,  license,  and  letters  describing 
pr«fi>ssional  qualifications,  those  forwarded  with  his  application  being  returned 
to  him  for  this  purpose.  n; 

255.  The  examination  is  conducted  in  the  following  order :  I.  Physical. 
II.  I'rofe.ssional. 

(n)  The  physical  examination  is  that  described  in  paragraph  130.  In  the 
case  of  candidates  for  the  Naval  Reserve  Force  alone  the  minimum  height 
retiuirod  is  64  inches.     (See  also  paragraph  2107.) 

(/))  I'rofessional  examination. —  (a)  Letter  to  the  board  describing  in  detail 
his  general  and  profes.sional  education. 

(b)  Examination  of  diplomas,  certificates  of  State  boards,  certificates  of 
membership  in  medical  societies,  letters,  and  such  other  recommendations 
or  certificates  bearing  upon  the  professional  qualifications  of  the  applicant 
;is  ho  may  desire  to  submit, 
(c)  The  candidate  will  be  expected  to  pass  an  oral  examination  as  follows: 
(a)  Practice  of  medicine,  to  include  the  etiolog>%  pathology,  .sympto- 
mology.  diagnosis,  prognoses,  and  treatment  of  disease. 

(h)   Practice  of  surgery,  to  include  surgical  anatomy,  surgical  pathology, 
general,  military,  and  naval  surgery. 

(r)   General  hygiene,  to  include  personal  hygiene,  preventable  diseases, 
clothing  and  equipment,  water  supply,  food,  disj^osal  of  waste,  air,  ventila- 
tion, heating,  lighting,  camp  .sanitation,  and  quarantine. 
The  oral  examination  will  be  sulRciently  comprehensive  to  determine  whether 
the  candidate  is  qualified  to  practice  medicine  under  the  usual  service  conditions. 

256.  Due  credit  will  be  given  for  knowledge  and  experience  in  the  case  of 
candidates  who  have  .sju'cialized  in  certain  branches,  and  the  examinati<»n  may 
be  modified  accordingly.  A  successful  candidate,  upon  the  completion  of  his 
examination,  will  be  notified  by  the  president  of  the  board  that  he  has  been 
found  qualified.  The  board  will  assign  an  average  mark  based  on  a  passing 
mark  of  7-")  per  cent. 

257.  With  the  consent  of  the  medical  examiners,  a  candidate  may  witlidraw 
at  any  i)eriod  from  further  examination  and  may  at  a  future  time  itrescnt 
himself  for  reexamination,  provided  that  such  examination  is  not  delaye*!  until 
after  tile  date  that  his  permit  would  expire. 

25S.  i\'o  allowance  will  be  made  for  the  expen.ses  of  persons  api)earing  for 
examination. 

25J).  If  the  medical  examiners  find  the  candidate  duly  qualified  physically 
and  [irofessionally  for  enrollment  In  the  provisional  grade  of  assistant  surgeon, 
rank  of  lieutenant,  j\inior  grade,  Naval  Coast  Defense  Reserve,  cla.ss  4,  United 
States  Naval  Reserve  Force;  or  Volunteer  Naval  Ke.serve  for  duty  in  the  Naval 
Coast  Defense  Ueserve,  class  4,  United  States  Naval  Iteserve  Force;  they  will 
immediately  forward  a  r('i)ort  and  rccomincnd.Mtion  to  this  eflcct  direct  to  the 
I'.urcau  of  .Medicinj'  and  Surgery,  together  with  the  certilit  ate  of  the  candidate 
as  to  his  physical  (•ondltion,  the  jiersonal  iiisinry  and  i)liysi<'ai  data  form,  and 
the  letter  of  the  candidate  to  the  medical  examiners.  A  report  and  recommen- 
dation will  also  be  made  when  a  candidate  is  found  disqualified. 

2(50.  After  approving  the  record  of  examination  and  the  recommendation  of 
the  medical  examiners  in  the  case  of  a  qualified  coudidale,  the  liureau  of  Medi- 


MANUAL   FOR   THE    MEDICAL  DEPARTMENT,   U*    S.    NAVY.  21 

cine  and  Surj;t>ry  will  reconunend  to  the  Bureau  of  Navlf;:ation  the  provisiouul 
enrollnicnt    >f  Ihc  ciiHlidate  in  flu-  United  States  Naval  itescrve  Force.        ( 

261.  A  inenihor  of  the  United  States  Naval  Reserve  Force  may  transfer  to  or 
from  the  Volunteer  Naval  Keserve  upon  approval  by  the  Bureau  of  Navigation 
of  his  request  tt»  this  effect. 

2(j2.  Confirmation  in  grade:  Assistant  sur,u;eon.s  provisionally  enrolled  in  the 
Naval  Coast  Defense  Keserve,  class  4,  United  States  Naval  Keserve  Force;  or 
Volunteer  Naval  Keserve  for  duty  in  the  Naval  Coast  Defense  Keserve,  Uniteil 
States  Naval  Keserve  Force,  who  apply  to  the  Bureau  of  Navigation  via  their 
commanding  officer  for  pern)ission  to  perform  the  minimum  amount  of  active 
service  required  (at  sea)  for  confirmation  in  grade,  and  who  after  completing 
the  active  service  recpiired  request  permission  to  be  examined  for  confirmation 
in  grade,  will  be  issued  a  permit  to  appear  for  examination  at  a  designat*?d 
place  l)efore  a  statutory  board  appointed  for  this  purpose. 

263.  (o)   The  physical  examination  Ls  that  described  in  paragraph  255.         . 
(&)   Professional  examination. —  (a)   Letter  to  the  board,  giving  a  bi'ief  state- 
ment of  the  candidate's  general  and  professional  education.      ]..i   ^-.a.  ,jij,;jHi;j^ 

(ft)   Examination  of  active  service  I'ecord.  .    iiinth\ii:/.'A   .8T!i 

(c)  Knowledge  of  Navy  Kegulations  and  Instructions,  General  .Orders; 
and  Manual  for  the  Medical  Department,  appropriate  to  grade;  medical 
department  duties  during  emergency  drills,  such  as  fire,  collision,  abandon 
ship,  battle  stations,  etc. 

(d)  Written  examination  in  (o)  anatomy,  (ft)  physiology,  (c)  materia 
niedica  and  therapeutics,  (d)  general  medicine,  (e)  general  surgery,  and 
(/)  obstretrics.     Two  or  more  questions  are  asked  in  each  subject. 

(e)  An  oral  examination  is  conducted  in  each  of  the  above  enumerated 
subjects. 

(/)  The  board  will  give  careful  consideration  to  composition  and  spelling 
as  shown  in  the  written  papers  submitted  by  the  candidate,  and  to  his 
service  record. 

(g)   Seventy -five  per  cent  is  required  as  a  general  average. 

264.  Those  assistant  surgeons  provisionally  enrolled  in  the  United  States 
Naval  Reserve  Force,  who  have  been  found  duly  qualified  for  confirmation  in 
grade,  and  who  will  be  within  the  age  limit  of  32  years  at  the  end  of  the  Naval 
Medical  School  course  and  on  receipt  of  commission,  may  apply  to  the  Bureau 
of  Navigation  via  the  Bureau  of  Medicine  and  Surgery  for  permi.ssion  to  enter 
the  Naval  Medical  School  with  a  view  to  further  instruction  and  training,  and 
to  subsequent  appointment  as  assistant  surgeon.  Medical  Corps,  United  States 
Navy.  If  authorized  to  attend  the  course  for  this  purpose  no  examination  will 
be  required  until  the  course  is  finished,  when  the  officer  will  be  examined  physi- 
cally and  professionally  for  appointment  as  assistant  surgeon,  United  States 
Navy. 

265.  Medical  officers  enrolled  in  the  United  States  Naval  Reserve  Force 
shall  be  appointed  in  time  of  peace  not  to  exceed  500  in  number.  To  provide 
for  promotion,  medical  ofiicers  who  reenroU  within  four  months  after  the  ter- 
mination of  each  enrollment,  and  who  have  performed  the  minimum  amount  of 
active  service  required  (at  sea),  each  enrollment,  may  receive  promotion  to  the 
rank  of  lieutenant  on  third  enrollment,  and  to  the  rank  of  lieutenant  com- 
mander on  the  fifth  enrollment,  upon  performing  the  minimum  amount  of  active 
service  required  (at  sea)  in  the  new  enrollment,  provided  they  are  found  quali- 
fied physically  and  professionally  on  examination. 

266.  The  uniform  of  officers  of  the  Naval  Re.serve  Force  shall  be  service 
dress  (blue  and  white),  but  uniforms  will  not  be  required  except  when  such 
officers  are  assigned  to  active  duty.  Officers  on  the  nonactive  list  may,  however, 
provide  themselves  with  uniforms  and  wear  same  upon  appropriate  occasions,  if 
they  so  desire. 

267.  Assistant  surgeons  in  the  Naval  Reserve  Force  who  are  assigned  to 
duty  in  attendance  upon  a  course  of  instruction  at  the  Naval  Medical  School  pre- 
liminary to  final  appointment  in  the  regular  corps  will  be  required,  during  the 


22  MANUAL   FOR   THE    MEDICAL  DEPAKTMENT,   U.    S.    NAVY. 

period  of  instruction,  to  provide  themselves  only  witli  IMue  service  uniforui  aud 
sword.  ,  ,    .      |.,, 

Section  13.— Information  Kegauutng  Appointment  in  the  Medicai,  CJobps  of 

THE  Naval  Militia. 

»71  Naval  Militia  officers  (Medical  Cori)S)  must  be  bt^tween  the  ages  of  18 
and  4;-)  years  on  first  entering  the  Naval  Militia,  but  they  niiiy  serve  until  they 
are  64  vears  of  age,  if  their  service  in  tlie  Naval  Militia  is  continuous. 

272.' When  so  authorized  by  the  Navy  Department,  the  examination  may  be 
wliolly  oral  l)Ut  sufticiently  comprehensive  to  determine  wliether  the  candidate 
is  competent  to  practice  medicine  under  the  usual  service  conditions.  If  Ike 
oral  examination  in  any  subject  is  unsatisfactory,  the  applicant  may  be  required 
to  take  a  written  aud  a  practical  examination  in  this  suliject.  It  is  not  Uie  pur- 
pose however,  to  authorize  the  oral  examination  e.xcept  in  instances  where  the 
Naval  Militia  is  musteretl  for  active  service,  aud  the  approved  professional 
standard  has  not  been  adopted  by  the  State.  ,..:,'' 

*73  Examinations  will  be  held  in  accordance  with  the  instructions  con- 
tained in  General  Order  No.  153,  page  29-31,.aiul  Appendices  A  and  3.  .;  , , 

i')'l    li;-.i!,M)/    M(U   ■  /.   bnii 

;■•  .::!••  ■.  -:■  i.t.  .-  :  ■■'■■•.■.'. 

r.i 

f.i 


.'     1.1  Mi/     ■•VIC    Milt      [  /    \  y  ,  'ij  LO 


•I'.di 


CHAPTER  3. 

THE  DENTAL  CORPS  AND  THE  NAVAL  RESERVE  FORCE. 

The  Dental  Corps. 

Section  1, — Laws  Relating  to  the  Dental  CoiiPS.     (AcTtA^/o,  2i2,'.lj94^,;,' Acji; 
Mar.  4,  1913;  Act  Aug.  29,  1916.)    ":".',;,'•;,.,  V"  ^^^  /, . 

301.  Dental  surgeon  at  Naval  Academy:  The  President  is  hereby  authorized,, 
by  and  with  the  advict  and  consent  of  the  Senate,  to  appoint  the  dentist  now  at 
the  United  States  Naval  Academy  a  dental  surgeon  in  the  Navy  for  duty  at  the 
United  States  Naval  Academy,  to  have  the  corresponding  rank,  pay,  and  allow- 
aucCj  as  the  senior  dental  surgeon  now  at  the  United  States  Military,  Academy : 
And  provided  further,  That  he  shall  not  be  eligible  for  retirement  before  he  has, 
reached  the  age  of  70  years  except  for  physical  disability  incurred  lin  the  linp;Of 
duty.     (Act  Mar.  4,  1913.)  .    , 

302.  Tbe  President  of  the  United  States  is  hereby  iiuthorized  to  aijpoint  and 
conunission,  by  and  with  the  advice  and  consent  of  the  Senate,  dental  surgeons 
in  the  Navy  at  the  rate  of  one  for  each  one  thousand  of  the  authorized  enlisted 
strength  of  the  Navy  and  Marine  Corps,  who  shall  constitute  the  Naval  Dental 
Corjis  and  shall  be  a  part  of  the  IMedical  Department  of  the  Navy. 

303.  (a)  Original  appointments  to  the  Naval,  Dental  Corps  shall  be.  proba- 
tionary for  a  period  of  two  years  and  may  be  revolted  at  any  time  during  the 
probationary  period  by  the  President. 

(ft)  The  I'anli  of  such  officers  of  the  same  date  of  appointment  among  them- 
selves at  tlie  end  of  said  probationary  period  shall  be  determined  by  the  recom- 
mendations of  an  examining  board  appointed  by  the  Secretary  of  the  Navy, 
which  board  shall  conduct  a  competitive  examination,  based  upon  both  service 
record  and  professional  attainments,  in  accordance  with  such  regulation.s  as 
may  be  pn^scribed  by  the  Secretary  of  the  Navy,  and  the  rank  of  sucli  ol1ic*ers 
.so  determined  sliall  be  as  of  date  of  original  apjiointment  with  reference  to  other 
appointments  to  tlie  naval  service. 

304.  All  appointees  to  the  grade  of  dental  surgeon  shall  be  citizens  of  the 
United  States  between  24  and  30  years  of  age,  and  shall  be  graduates  of  stand- 
ard medical  or  dental  colleges  and  trained  in  the  several  brandies  of  dentistry:, 
and  who  shall,  before  appointment,  have  successfully  passed  moral,  physical, 
and  professional  examinations  before  medical  and  professional  examining  boards  , 
appointed  by  the  Secretary  of  the  Navy,  and  have  been  recommended  for  appoint- 
ment by  such  boards. 

305.  (a)  Dental  surgeons  shall  have  the  rank,  pay,  and  allowances  of  lieu- 
tenants (junior  grade)  until  tliey  shall  have  c<  mpleted  five  years'  service. 
Dental  surgeons  of  more  than  5  but  less  than  20  years'  service  shall,  subject  to  i 
such  examinations  as  the  Secretary  of  the  Navy  may  prescribe,  have  the  rank, 
pay,  and  allowances  of  lieutenant.  Dental  surgeons  of  more  than  20  years' 
service  shall,  subject  to  such  examinations  as  the  Secretai-y  of  the  Navy  may 
prescribe,  have  the  rank,  pay,  and  f  llowances  of  lieutenant  conunander. 

23 


24  MANUAL   FOR    THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

ih)  The  total  number  of  dt'iital  surjieons.  with  the  rank,  paj',  and  allowances 
of  lieutenant  connnander  shall  not  at  any  time  <'xeee<l  10. 

((■)  oni<ers  of  the  l>ental  ('ori)s  are  entitled  to  ail  (he  military  courtesies  and 
consideration  that  no  with  that  rank  and  are  accorded  to  olticers  of  other 
branches  of  the  service  in  a  similar  j;rade.  They  wear  the  same  unifonn  as 
other  ollicers  of  the  Navy  with  a  desifinating  device  distinctive  of  their  corps. 
(See  Uniform  Regulations,  1913,  pars.  G  (a),  125.) 

{(I)  The  tenure  of  ofli<e  in  the  Dental  Corjis  of  the  Navy  is  for  life,  unless 
sooner  terniinate<l  by  nnnoval.  resignation,  disability,  or  other  casualty. 

306.  (a)  All  ollicers  now  in  the  Dejital  Corps  (including  the  officers  appointed 
for  temporary  service)  api)ointetl  under  the  provisions  of  the  act  of  August 
22,  1912,  entitled  "An  act  making  appropriations  for  the  Naval  Service  for 
the  liscal  year  ending  June  thirtieth,  nineteen  hundred  and  thirteen,  and 
for  other  purposes,"  and  all  officers  now  in  active  service  appointed  under  the 
provisions  of  the  act  of  March  4,  1013,  who  were  eligible  for  appointment  to 
the  Dental  Corps  under  the  provisions  of  said  act,  shall  be  appointed  dental 
surgeons  in  the  Dental  Corps  witliout  further  examination  and  without  regard 
to  the  age  qualifications  herein  prescribed. 

(b)  The  officers  so  appointed  shall  not  be  subject  to  the  provigioqs  herein 
prescribed  for  probationary  service  for  a  period  of  two  years.      '  • 

(c)  Such  officers  .shall,  after  appointment  as  herein  prescribed,  rank  from 
date  of  connnlssion  and  take  seniority  among  themselves  In  the  order  of  their 
original  appointment  by  the  Secretary  of  the  Navy  as  shown  on  the  Navy  list 
on  the  date  of  approval  of  tliis  act.    ' 

807.  No  dental  surgeon  appointed  in  accordance  with  the  provisions  of  this 
act  who  on  original  appointment  to  the  Dental  Corps  was  over  40  years  of' 
age  shall  be  eligible  for  retirement  before  he  has  reached  the  age  of  70  years, 
except  for  physical  disability  incurred  in  the  line  of  duty. 

308.  Dental  surgeons,  who  shall  have  lost  numbers  on  the  Navy  list  by 
sentence  of  court-martial  or  by  failure  upon  examination  for  promotion  shall 
be  Considered  to  liave  lost^service  accordingly  for  puri)oses  of  adVkuceniebt  lu 
rank  with  increased  pay  and  allowances.     (Act  of  Aug.  29,  1916.) 

SbJCTIoK  2. — INFORMATION' Regarding  Appointments  in  the  Dental  Corps. 

311.  A  candidate  for  appointment  lo  the  Dental  Corps  of  the  Navy  as  dental 
surgeon  must  be  a  citizen  of  the  United  States,  between  24  and  30  years  of  age, 
a  graduate  of  a  standard  medical  or  dental  college,  trainetl  In  the  several 
branches  of  dentistry,  of  good  moral  character,  and  of  unquestionable  profes- 
sional repute. 

312.  Application  for  a  permit  to  take  the  examination  should  be  nuide  to 
the  Chief  of  the  I'.ureau  of   Navigation,  Washington,   D.   C,   via    the   Surgeon 
Ceneral,   United    States   Navy,    and   a<<-onling   to   the    form   prescribed.     This 
abdication  must  be  in  the  handwriting  of  the  candidate  and  must  be  accom«. 
panied  bv  the  following  certificates:  .  ■    «' 

((()    Letters  or  cerlific  ati's  from  two  or  more  persons  of  good  repute,  testify)  . 
in^  fi-om  personal  kfiovvledge  to  good  haliits  and  moral  chara<'ter. 

'}h)  A  certificate  to  the  eftect  that  the  applicant  Is  a  citizen  of  the  United 
States.  .     .  .    '  '■    ...1  !,!.^: 

(c)  Certificnte  of  pi-elimiiiary  education.    The  candidate  iu«*t  submit. iaf/cteri-.. 
litif-ate  of  graduation  from  an  accepted  lugh  school  or  an  acceptable  equlvaleht. 

(if)  Certificate  of  dental  education.  This  certificate  should  give  the  name 
of  the  si-hodl  and  the  dale  (tf  gradiiafion. 

{*■)  If  the  caiKlidate  has  had  sixnial  educational  or  i)rofessioual  advantages, 
certificates  to  this  efl'ect,  signed  by  the  proixM"  authorities,  should  ais*)  be 
forwarded. 

The  iipi^licant  will  save  Unnecessary  rorresiKJudeneelf  he  will  make  sure  when 
subndttiirg  his  ai)plication  that  the  qunIitH  ations  einimeiiited  above  are  clearly 
and  i»lainly  deseribed  in  his  leth'rs  or  <-<'rtilieales. 


MANUAL    FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 


25 


313.  Application  for  eiirolliuent  must  be  nitule  in  the  handwriting  of  the 
.•ipi)licant  accortliny  to  the  following  form: 

Sir:    I   reiiuest    j)ermi.s8ion   to  be   examined   for   an   appointment   as   dental 

surgeon  in  the  United  States  Navy.     I  was  born  at ---■ ,  ami 

was years  of  age  ou  the day  of -,  191— ;  tii"  a 

citizen  of  the  United  States,  residing  in ,  county  of . 

in  the  State  of I  am   a   gradmite  of —  dental 

(medical)   school,  in  the  State  of -^— — ,  and  was  licensed  to 

practice  dentistry  in  the  State  of :— in  '— --^^-z"    ■^■ 

I  forward  herewith  letters  testifying  to  my  moral  character,  habits,  citizen- 
ship, preliminary  education,  professional  education,  and  qualificatious. 
Very  respectfully, 

'■  ''• '  '^'^  (Sign  the  name  in  full.) 

The  Chief  of  the  Bureau  of  Navigation, 

Navy  Department,  Wasliinyton,  D.  C^. 

( via  The  Surgeon  General,  Unite,d  States  Navy ) . 

314.  A  candidate  w^hose  preliminary  qualifications  appear  to  be  satisfactory 
will  receive  a  formal  permit  to  present  himself  for  examination. 

When  a  candidate  presents  himself  for  examination  he  must  bring  with  hm. 
the  testimonials  as  to  character  and  professional  fitness,  diploma  of  preliminary 
and  professional  education,  and  a  certificate  that  he  is  a  citizen  of  the  United 
States;  those  forwarded  with  his  application  being  returned  to  him  for  this 

^^"315.  'the  examination  is  conducted  in  the  following  order:  I.  Moral.  11. 
Physical.     III.  Professional.  .,  .      '.' 

(a)  The  physical  examination  is  thorough,  and  the  candidate  is  required  to 
certify  on  oath  that  he  is  free  from  all  mental,  physical,  and  constitutional  de- 

**^Acuteness  of  vision,  12/20  for  eacli  eye,  tinaided  by  glasses,  but  capable  of 
correction,  by  aid  of  lenses,  to  20/20  is  obligatory.  Color  perception  must  be 
normal  and  the  teeth  good.  .„    ,   ,  .  ■  \- 

If  the  candidate  is  found  to  be  physically  disqualified,  his  examination  is  con- 
cluded ;  if  found  to  be  physically  qualified,  his  examination  is  continued   as 

^^^^bTVrofessional  examination.  Letter  to  the  board  describing  in  detail  ,his 
ceueral  and  professional  education.  ,      •, 

Theoretical  (written  and  oral)  in  the  following  subjects:  Anatomy,  physi- 
olo-v  histology,  phvsics,  chemistry,  metallurgj-,  dental  materia  medica  and 
therapeutics,  dental  'pathology  and  bacteriology,  orthodontia  oral  surgery,  op- 
erative dentistry   (theory),  and  prosthetic  dentistry    (theory).  ; 

Practical  (clinical)  in  operative  dentistry  and  prosthetic  dentistry,  _ 

An  oral  examination  is  conducted  in  the  following  subjects  of  preliminary 
education:  Arithmetic,  grammar,  general  history,  physics,  general  literature, 
and  Latin.  Amilicants  holding  diplomas  or  certificates  from  reputable  hterary 
or  scientific,  colleges,  normal  schools,  or  high  schools  may  submit  such  diplomas 
or  certificates  for  the  consideration  of  the  board  in  this  connection. 

316.  A  successful  candidate,  upon  completion  of  his  examination,  will  be 
notified  bv  the  president  of  the  board  that  he  has  been  found  qualified. 

-317.  With  the  consent  of  the  board,  a  candidate  may  withdraw  at  any  period 
from  further  examination,  and  may  at  a  future  time  present  himselt  for  re- 
examination. The  board  may  conclude  the  examination  (written,  oral,  and 
practical)  at  any  time,  and  anay  deviate  from  this  general  plan  as  it  may  deem 
best  for  the  interests  of  the  naval  service.  /  .  ,^    ;       , 

318.  No  allowanci;  will  be  made  for  the  expetlse' of  persons  .a^peamtig  for 
examinatii)U. 


26  MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

SECTlroN   3. — NA^^r   Regulations   and  Navai,   iNSTRrcTroNs   RKr.ATiNo   to  the 

Dkntal  Coups. 

331.  L>ent:il  (»flic(M-  of  the  ship  forms  part  of  the  surgeon's  division.     I  2130  (1). 

332.  Qualitications  for  appoiutraent.     R  29S8.  .. 
''  333.  Appointment  subject  to  examination.     R  2988. 

'    334.  Pliysical  examination  by  three  metlical  otticers.     R  2989. 

335.  Professional  examination.     R  299U. 

''  33(J.  Duties,  sorvicos,  and  assignments.     R  2991. 

337.  Attfiitioii  to  patients.     R  2992,  R  2993. 

33S.  Records  of  treatments.     R  2994. 

33y.  Responsibility  for  dental  property.     R2995. 

340.  Reqaisitions  and  returns.    R  2996.       ■"■■t'l  •• 

Section   4. — In.structions   RB:r.ATiNO  to   the   Professtonat.   Examination   of 
Dental  Surgeons  at  Enu  of  Probationary  Period. 

•:  ■     ...       ■('      ■■  ■,  I'l 

346.  Professional  examination. 

(«)  A  letter  to  tije"  board  giving  an  account  of  the  candidate's  general  and 
professional  duties  since  his  admission  to  the  service. 

Uj)  Examination  (theoretical)  in  anatomy  (general  and  dental),  physiology 
(general  and  dental),  histology,  physics,  chemistry,  metallurgy,  dental  materia 
nu.'diea  and  therapeutics,  dental  ixithology  and  bacteriology,  orthodontia,  oral 
surgery,  operative  dentistry,  prosthetic  dentistry,  duties  of  naval  dental  officers, 
and  Navy  Regulations  and  Instructions. 

(c)  Examination  (practical)  in  iirosthetic  dentistry  and  operative  dentistry. 

(<J)  General  efficiency  (reports  of  fitness  and  such  other  relevant  matter  as 
may  be  submitted  by  the  candidate  or  obtained  by  the  board  to  determine  the 
candidate's  fitness). 

347.  If  any  candidates,  from  their  general  manner,  conduct,  bearing,  ap- 
pearance, or  from  adverse  reports  received,  are  in  the  opinion  of  the  board 
nnqualined  the  board  will  state  this  fact  in  its  findings;  and  in  each  case  the 
reuscjns  in  detail  for  the  adverse  opinion  will  be  so  definitely  stated  as  to  admit 
no  doubt  of  what  is  meant,  and  referred  to  the  candidate,  who  will  be  permitted 
to  make  a  specific  reply,  ,^l 

Section    5. — Insteuctions    Relating   to   the   Naval   Res1':bve   Force.      (Act^ 

Aug.  29,  191G.)  , 

'^^"SSI.  A  candidate  for  enrollment  as  a  dental  officer  is  first  examined  for 
enrollment  in  the  provisional  grade  of  denial  surgeon,  rank  of  lieutenant  (junior 
grade).  United  States  Naval  Reserve  Force.  Afterwards  if  his  enrollment  is 
a<c<imi)li.shed,  should  he  .so  desire,  he  makes  request  for  active  duty  for  cori; 
firmation  in  grade,  and  after  the  completion  of  a  minimum  period  of  three 
inontlis'  active  service  (at  sea)  he  is  again  examined,  and  if  found  qualified 
is  recommended  for  a  conunission  as  a  dental  surgeon,  United  States  Naval 
Re.serve  Force.  Legislation  eslablislung  the  United  States  Naval  Reserve  Force 
contains  in  subsUince  matter  referable  to  tLo  grade  of  dental  surgeon  as  to\- 

((/)  A  member  must  be  a  citizen  of  the  T'nited  States,  except  as' noted  beloW 
with  reference  to  the  Naval  Auxiliary  Reserve.  •,'     ■"  -"'^-  »*      -     •»» 

(//)   A  member  obligates  himself,  and  may  be  ofdered  tO' seH'C  In  the  Nflvy 
(In-oughout  a  war  or  during  the  existence  (»f  a  nathmal  emergency  d^clni-ed 
by  the  President,  shouhi  either  arise  dur,ing  his  term  of  enrollment.       . 
'  (c)   A  memlier  enrolls  or  reenroUs  f<»i*  a  term  of  four  years. 

(d)  In  time  of  iK'ace,  and  when  no  national  emergency  exists,  a  member  may 
be  discbar^'ed  iqion  his  own  request,  upon  reimi)ursiiig  the  Government  for  any 
clotiiinn  gratuity  tliat  mav  have  been   furnished  during  hi3  current  enrollment. 

(,)    A  member  is  ivquiri-d  to  take  the  oatli  of  allegiance  to  the  United  States 


MANUAL  FOR   THE    MEDICAL  DEPAETMENT,   U.    S.    NAVY.  27 

(/)  A  lueiiibor  is  given  a  provisional  prade  (dental  surgeon)  upon  first,  en- 
rollment in  accordance  with  his  qualitications  determined  by  examination. 

(g)  A  member  after  enrolling  may,  in  time  of  peace,  upon  his  own  request, 
be  assigned  active  duty  in  tlie  Navy  for  such  periods  of  instruction  and  train- 
ing as  may  enable  him  to  qualify  for  and  be  confirmed  in  grade. 

(h)  For  confirmation  in  grade  a  member  must  serve  the  minimum  amount 
of  active  service  required  (three  months)  and  must  qualify  by  examination 
under  regulations  prescribed  by  the  Secretary  of  the  Navy. 

(i)  The  minimum  active  service  required  for  maintaining  the  efficiency  of 
a  member  (Naval  Coast  Defense  Reserves)  is  three  months  during  each  term 
of  enrollment.  This  active  service  may  be  in  one  period  or  in  periods  of  not 
less  than  three  weeks  each  year. 

(j)  No  person  shall  be  appointed  or  commissioned  an  officer  in  asy  rank  in 
any  class  of  the  United  States  Naval  Reserve  Force,  or  promoted  to  a  higlier 
rank  therein,  unless  he  shall  have  been  examined  and  recommended  for  such 
appointment,  commission,  or  promotion  by  a  board  of  three  naval  officers  not 
below  the  rank  of  lieutenant  commander,  nor  until  he  shall  have  been  found 
physically  qualified  by  a  board  of  medical  officers  to  perform  the  duties  required 
in 'time  of  war,  except  that  former  officers  and  midshipmen  of  the  Navy  who 
shall  have  left  the  service  under  honorable  conditions  and  who  shall  have 
enrolled  in  the  United  States  Naval  Reserve  Force  may  be  appointed  in  the 
grade  and  rank  kist  held  by  them  without  examination  other  than  the  physical 
examinations  herein  prescribed. 

(k)  A  member  receives  retainer  pay  of  $12  per  annum  while  enrolled  in  a 
provisional  grade,  provided  he  makes  such  reports  concerning  his  movements 
and  occupation  as  may  be  required  by  the  Secretary  of  the  Navy.  After  con- 
firmation in  grade  his  annual  retainer  pay  is  two  months'  base  pay  of  the 
corresponding  rank  in  the  Navy.  Retainer  pay  is  in  addition  to  any  pay  to 
which  a  member  may  be  entitled  by  reason  of  active  service.  As  noted  below, 
members  of  the  Volunteer  Naval  Reserve  do  not  receive  any  retainer  pay. 

(l)  A  member  who  reenrolls  for  a  term  of  four  years,  within  four  months 
of  expiration  of  last  complete  enrollment,  and  who  has  performed  the  minimum 
amount  of  active  service  required  during  the  preceding  term  of  enrollment,  for 
each  reenrollment  receives  an  increase  of  25  per  tent  of  his  base  retainer  pay. 
A  member  who  completes  20  years  of  service,  and  who  has  performed  the  mini- 
mum amount  of  active  service  each  term  of  enrollment,  on  his  own  application 
will  be  retired  with  rank  held,  with  a  cash  gratuity  equal  to  the  total  amount  of 
his  retainer  pay  during  his  last  term  of  enrollment. 

<m)  A  member  may  accept  employment  in  any  branch  of  the,. public  service, 
except  as  an  officer  or  enlisted  man  in  any  .branch  of,  tlie,  military  service,. of  t^^ 
United  States  or  any  State  thereof.  ,      .-  \.     ^,  ;-'i.-: 

(n)  A  member  is  subject  to  the  laws,  regulations,  and  orders  for, the  govern- 
ment of  the  Regular  Navy  only  during  such  time  as  he  may  by  law  be  required 
to  serve  in  the  Navy  in  accordance  with  his  obligation,  and  when  on  active 
service  at  his  own  request,  and  when  employed  in  authorized  travel  to  and 
from  such  active  service  in  the  Navy.  ,     i_ 

(0)  A  distinctive  badge  or  button  will  be  issued  to  be  worn  only  by  mem- 
bers of  the  United  States  Naval  Re.serve  Force.  A  penalty  is  assigned  for 
wearing  or  use  of  this  emblem  by  unauthorized  persons.  ■ ' ' " 

(«)  A  member  actively  employed  receives  the  same  pay  and  allowances,  gra- 
tuities and  other  emoluments  as  an  officer  of  the  Naval  Service  on  active  duty 
of  corresponding  rank  and  of  the  same  length  of  service.  When  not  actively 
employed  a  member  is  not  entitled  to  pay,  bounty,  gratuity,  or  pension,  except 
as  expressly  Provided  by  the  provisions  of  the  act.  .  \     . 

(q)  When  first  reporting  for  active  service  for  training  during  each  period  of 
enrollment  officers  are  credited  with  a  uniform  gratuity  of  $50,  except  as  noted 
below  with  reference  to  the  Volunteer  Naval  Reserve.  In  time  of  war  of 
national  emergency  they  are  credited  with  $150,  less  the  amount  previously 
credited,  ;taoy,,during  the  current  enronment.^^ ^  ^^  .  .  ^  ,.,..  „  . 

•  .ijio  i  •t'ftf-~i3i   li'./i:/-  1'.)  .'j.Tjf-'irt  -^^ut'lttt  iaao't  ia/B/i'     I'triuw  •Jiil   lut 


28  MANUAL   FOR   THE   MEDICAL   DEPABTMENT,   U.    S.    NAVY. 

(r)  Officers  in  the  United  States  Naval  Reserve  Force  rank,  with  but  after 
(.diicis  of  corresponding  raulc  iu  the  Navy.  Officers  are  commissioneil  hy  thy 
I 'resident. 

852.  (a)  Enrollment  of  persons  (not  previously  connected  with  the  Ueyular 
Navy),  except  enrollments  in  the  Naval  Auxiliary  Reserve,  class  3,  United 
States  Naval  Reserve  Force,  as  dental  surjieons,  United  States  Naval  Reserve 
Force,  shall  be  made  in  the  Naval  Coast  Defense  Reserve,  class  4.  or  Volunteer 
Xaval  Reserve  for  duty  iu  the  Naval  Coast  Defense  Reserve,  class  4,  United 
States  Naval  Reserve  Force.  (Members  of  the  Volunteer  Naval  Reserve  receive 
n<»  retainer  pay  or  uniform  gratuity  iu  time  of  peace,  but  when  on  active  duty 
I  hey  receive  the  service  pay  of  their  grade  and  service. ) 

{b)  Citizens  of  the  United  States  or  of  its  insular  possessions  of  the  sea- 
froing  profession  who  shall  have  been  or  may  be  employetl  on  American  vessels  of 
llie  merchant  marine  of  suitable  type  for  use  as  naval  auxiliaries,  and  which 
shall  have  been  listed  as  such  by  the  Navy  Department  for  use  in  war,  shall  be 
eligible  for  membership  in  the  Naval  Auxiliary  Reserve  as  dental  surgeons,  sub-, 
iect  to  the  examinations  hereinafter  prescribed.  Their  annual  retainer  pay, 
after  contirmatiou,  is  one  month's  base  pay  of  the  corre.spondiug  rank  in  the 
Navy. 

(c)  A  candidate  for  enrollment  as  above  must  be  between  21  and  44  years  of 
age  and  a  citizen  of  the  United  States,  except  as  noted  above  with  reference  to 
the  Naval  Auxiliary  Reserve.  He  must  be  a  graduate  of  a  reputable  dental 
or  medical  school,  legally  authorized  to  confer  the  degree  of  doctor  of  dental 
surirery. 

353.  Application  for  enrollment  must  be  made  in  the  handwriting  oi  the 
:ipi>licant  according  to  the  following  form: 


(Ilesideuco.) 


19_ 


Siu :  I  re 
rrade  of  dent 


quest  permission  to  be  examined  for  enrollment  in  the  provisional 

^ „^  ..^ntal  surgeon,  rank  of  lieutenant,  junior  gi-ade.  Naval  Coa.st  Defense 

Reserve'  class  4,  United  States  Naval  Reserve  Force.* 

I  was  born  at    __     — -.  and  was ,  years  of  age  on  the  ___w__ 

(l-iy  of " -— ,  191- ;  graduated  from dental  (medi- 

cid)    school' ih   19-^   and    atu    licensed    to    practice   dentistry  in  ' the    State 

fam  a  citizeilof  the' United  States,  residing  In ^ — ^—-J^±f  county  bf 

,  in  the  State  of — .  '"' 

I  forward  herewith  letters  testifying  to  my  moral  <-haraeter,  habits.. citizen- 
ship, preliminary  education,  dental  education,  society  membershiit,  license  to > 
practice  dentistry,  and  professional  qualification.s.  "I'l 

Very  resi)ectfully, 

(Name  Tn  full  writt»sa,l«gii>ly.) 
Chief  of  the  BukeAu  of  Medtcinb  and  Sx'Rgery,  ..  -iiM 

Navy  Department,  Washington,  p.  G.  '  -.vm  ,■  , 

3r»4.   (a)  The  above  apiJlcatiou  must  be  occonipaniod  by  tlie  following"  cer- 

tili<-ates:  -  ,  i.      v    xi«;t..,. 

Letters  or  certificates  from  two  or  more  persons  of  good  rii'pute,  testirying 
from  personal  knowledge  to  good  Imblts  and  moral  character. 

A  certiticatc  or  stiiteinent  from  some  person  of  good  repute  that  the  applicant 
is  a  citizen  of  the  United  States.  In  case  the  applicant  is  a  naturallzi^l  citizen 
of  the  United  States  his  naturalization  papm^  orotjier  satisfactory  evidence  Of, 
citizenship,  must  be  submitted.  .  .-a^xJ 

C^rtiticate  of  preliminary  education.    The  candidate  must  submit  a  certificate 
of  graduation  from  an  acceiittnl  high  scliool  or  au  acceptable  equivalent. 

'When  (llrectpd,  the  appllcaut  slioiilsl  .substitute  tbe  words  "  VoUint.-er  Naval   lleserve 
for  duty  Iu  the  Naval  Coast  l»efeuse  Keserve,  tlass  4.  linlted  Stales  Nava    Ueserve  K.rce, 
for  the  words  ••  Naval  Coast  Defeuse  Ueser .  e,  .  lass  4.  Tiilled  Slates  .Naval  Ueserve  loive. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.  29 

Certificate  of  dental  education.  This  certificate  should  give  the  name  of  the 
school  and  the  date  of  graduation.  ,    .     .  . 

A  certificate  from  the  president  or  secretary  of  a  State  or  local  dental  society 
to  the  effect  that  the  applicant  is  a  member  in  good  standing. 

A  certificate  of  license  to  practice  dentistry. 

If  the  candidate  has  had  hospital  service  or  special  educational  or  professional 
advantages,  certificates  to  this  effect,  signe<l  by  the  proper  authorities,  should 

also  be  forwarded,  .^  x        .,,        , 

(&)  The  applicant  will  save  unnecessary  correspondence  if  he  will  make  sure 
when  submitting  his  application  that  the  qualifications  enumerated  above  are 
clearlv  and  plainly  described  in  his  letters  or  certificates. 

(c)' After  passing  upon  the  credentials  of  the  candidate  the  Bureau  of  Medi- 
cine and  Surgery  will  issue  a  permit  to  the  candidate,  effective  for  a  stated 
period  to  appear  before  medical  and  dental  examiners  designatefl  by  the  bureau 
via  the  commandant  or  commanding  officer,  for  his  provisional  physical  and  pro- 
fessional examination.  The  permit  will  direct  the  candidate  to  communicate 
with  the  senior  medical  examiner  as  to  the  date  and  place  of  examination.  An 
effort  will  be  made  to  select  the  place  of  examination  as  near  as  possible  to  the 
place  of  residence  of  the  candidate.  ,  ,    ^      ,  . 

(d)  When  a  candidate  presents  himself  for  examination  on  the  date  nxe<l  by 
the  senior  examiner  he  must  bring  with  him  the  testimonials  as  to  character, 
habits  citizenship,  preliminary  education,  dental  education,  membership  in  a 
State  or  local  dental  .society,  license,  and  letters  describing  professional  quali- 
fications, those  forwarded  with  his  application  being  returned  to  him  for  this 

^"35?  The    examination    is    conducted    in    the    following    order :  1.  Physical. 

II.  Professional.  ,   .  ,.   o-.r-      t     .u 

(a)  The  physical  examination  is  that  described  in  paragraph  315.  In  the 
case  of  candidates  for  the  Naval  Reserve  Force  the  minimum  height  required  is 
64  inches.     (See  also  par.  2107.)  ,      ,  ^  .,  t  • 

(5)  Professional  examination.  Letter  to  the  board  describing  in  detail  his 
general  and  professional  education. 

Examination  of  diplomas,  certificates  of  State  boards,  certificates  of  member- 
ship in  dental  societies,  letters,  and  such  other  recommendations  or  certificates 
iaearing  upon  the  professional  qualifications  of  the  applicant  as  he  may  desire 

to  submit.  .  ,,,,,, 

Oral  examination  in  the  several  usual  subjects  in  a  standard  dental  course, 

to  include  operative  dentistry,  prosthetic  dentistry,  and  oral  hygiene. 

A  practical  examination  in  operative  and  prosthetic  dentistry   may  be   re- 

*^^This  examination  will  be  sufficiently  comprehensive  to  determine  whether 
the  candidate  is  qualified  to  practice  dentistry  under  the  usual  service  condi- 
tions. ,  .  .        iT  Jf  1- 

Due  credit  will  be  given  for  knowledge  and  experience  in  the  case  of  candi- 
dates who  have  specialized  in  certain  branches,  and  the  examination  may  be 
modified  accordingly.  A  successful  candidate,  upon  the  completion  of  his 
examination,  will  be  notified  by  the  president  of  the  board  that  he  has  been 
found  qualified.  The  board  will  assign  an  average  mark  based  on  a  passing 
mark  of  75  per  cent. 

356.  With  the  consent  of  the  examiners,  a  candidate  may  withdraw  at  any 
period  from  further  examination  and  may  at  a  future  time  present  himself  for 
reexamination,  provided  that  such  examination  is  not  delayed  until  after  the 
date  that  his  permit  would  expire. 

357.  No  allowance  will  be  made  for  the  expenses  of  persons  appearing  for 

examination.  ,. ,  ^      ,  ,  i-^  j 

358.  If  the  medical  and  dental  examiners  find  the  candidate  duly  qualified 
physically  and  professionally  for  enrollment  in  the  provisional  grade  of  dental 
surgeon,  rank  of  lieutenant,  junior  grade.  Naval  Coast  Defense  Reserve,  class  1, 
United  States  Naval  Reserve  Force;  or  Volunteer  Naval  Reserve  for  duty  in 


30  MANUAL   FOR    THE   MEDICAL  DEPARTMENT,  U.    S.    NAVY. 

the  Naval  Coast  nofciise  Reserve,  class  4,  United  States  Kaval  Ueserve  Force; 
they  will  immetllMtely  forward  a  report  and  reconnneudation  to  this  effect  ilirect 
to  Mie  Bureau  of  Medicine  and  Surgery,  tofrether  with  the  certificate  of  the 
candidate  as  to  his  physical  condition,  the  personal  history  and  physical  data 
form,  and  the  letter  of  the  candidate  to  the  examiners.  A  report  and  recom- 
mendation will  also  be  made  wlien  a  candidate  is  found  disqualified.    ,  i 

359.  After  approving  the  record  of  exannnation  and  the  recommendation  of 
th(>  examiners  in  the  case  of  a  qualified  candidate,  the  Bureau  of  Medi<'ine  and 
Surgery  will  recommend  to  the  Kureati  of  Navigation  the  provisional  enrollment 
of  the  candidate  in  the  United  States  Naval  Reserve  Force. 

3(>0.  Upon  acce]tling  the  certificate  of  enrollment  the  candidate  is  reqijirod 
to  take  the  oath  of  allegiance,  and  to  certify,  on  oath,  as  to  his  citizen-sldp  and 
age. 

361.  A  member  of  the  United  States  Naval  Reserve  Force  may  transfer  to 
or  from  the  Volunteer  Naval  Reserve  upon  approval  by  the  Bureau  of  Naviga- 
tion of  his  request  to  this  effect. 

362.  Conlirujation  in  grade :  Dental  surgeons  provisionally  enrolled  in  the 
Naval  Coast  Defense  Reserve,  class  4,  United  States  Naval  Reserve  Force ;  or  Vol- 
UTiteer  Naval  Reserve  for  duty  in  the  Naval  Coast  Defense  Reserve,  Unite<l  States 
Naval  Reserve  Force,  who  apply  to  the  Bureau  of  Navigation  via  their  com- 
manding officer  for  permission  to  perform  the  uuniimim  amount  of  active  service 
required  (at  sea)  for  confirmation  in  grade,  and  who  after  completing  the  active 
service  rtniuired  request  pel-mission  to  be  examined  for  confirmation  in  grade, 
will  be  issue<l  a  permit  to  appear  for  examination  at  a  designated  place  before 
a  statutory  board  appointed  for  this  purpose. 

363.  (,o)  The  physical  examination  is  that  described  in  paragraph  355. 

(/()  Professional  examination:  L(>ttpr  to  the  board,  giving  a  brief  statement 
of  the  candidate's  gcuieral  and  professional  education. 

E.xauunation    of   active    service    record.  .   .'•,,,, 

Knowledge  of  Navy  Regulations  and  Naval  Instructions,  Gen6ra,t  Orders,  aijid 
Manual  for  the  Medical  Department,  appropriate  to  grade;  medical  department 
duties  during  emergency  drills,  such  as  fire,  collision,  abandon  ship,  battle 
stations,  etc.    ..     ,  i..  ,  ■  r    ' 

Theoretical  (writteff 'arid  oral)  in  the  following  subjects :  Aiiatoiby,  physio^ 
ogy,  histology,  physics,  cheriiistry,  metallurgy,  dental  materia  rhedica  and  thfrk- 
peutics,  dental  pathology  and  bacteriology,  orthodontia,  oral  surgery,  operative 
dentistry   (theory)  and  prosthetic  dentistry   (theory). 

Practical    (clinical)    in  operative  dentistry  and  prosthetic  dentistry. 

An  oral  examination  is  conducted  in  the  following  subjects  of  preliminary 
education:  Arithmetic,  grammar,  general  history,  physics,  general  literature, 
and  Latin.  Applicants  holding  diploma.s  or  certificates  from  reputable  literary 
or  scientific  colleges,  normal  schools,  or  high  schools  may  submit  stich  diplomas 
or  certificates  for  the  consideration  of  the  bo<ird  in  this  connection. 

The  board  will  give  careful  consideration  to  composition  and  spelling  a^ 
shown  in  the  wt-ittOn  papers  submitted  by  the  candidate,  and  to  his  service 
record.    '  ' 

.\s  a  general  average,  7^  i^ier  cent  is  reciuirwl. 

364.  The  uniform  of  officers  of  the  Na\al  Reserve  Force  is  as  prescribed  In 
paragraph  !260. 


CHAPTER  4. 


THE  HOSPITAL  CORPS. 

Section  1. — Laws  Relating  to  the  Establishment  of  the  Hospital  Corps. 
(Acts  June  17,  1898;  May  13,  1908;  Aug.  22,  1912;  Aug.  29,  1916.) 

401.  Hereafter  the  authorized  strength  of  the  Hospital  Corps  of  the  Navy 
shall  equal  3J  per  centum  of  the  authorized  enlisted  strength  of  the 
Navy  and  Marine  Corps,  and  shall  be  in  addition  thereto,  and  as  soon  as 
the  necessary  tran.sfers  or  appointments  may  be  effected  the  Hospital  Corps 
of  the  United  States  Navy  shall  consist  of  the  following  grades  and  ratings: 
Chief  pharmacists,  pharmacists,  and  enlisted  men  classified  as  chief  pharma- 
cist's mates ;  pharmacist's  mates,  first  class ;  pharmacist's  mates,  second  class ; 
pharmacist's  mates,  third  class ;  hospital  apprentices,  first  class ;  and  hospital 
apprentices,  second  class ;  such  classifications  in  enlisted  ratings  to  correspond 
respectively  to  the  enlisted  ratings,  seaman  branch,  of  chief  petty  ofhcers;  petty 
officers,  first  cla.ss ;  petty  officers,  second  class ;  petty  officers,  third  class ;  sea- 
men, first  class ;  and  .seamen,  second  class :  Provided,  That  enlisted  men  of 
other  ratings  in  the  Navy  and  in  the  Marine  Corps  shall  be  eligible  for  transfer 
to  the  Hospital  Corps,  and  men  of  that  corps  to  other  ratings  in  the  Navy 
and  the  Marine  Corps. 

402.  Hospital  and  ambulance  service  with  such  commands  and  at  such  places 
as  may  be  prescribed  by  the  Secretary  of  the  Navy,  shall  be  performed  by 
members  of  said  corps,  and  the  corps  shall  be  a  constituent  part  of  the  Medical 
Department  of  the  Navy ;  and  the  enlisted  men  thereof  shall  be  a  part  of  the 
enlisted  force  provided  by  law  for  the  Navy. 

403.  Section  3  of  an  act  entitled  "An  act  to  organize  a  Hospital  Corps  of 
the  Navy  of  the  United  States;  to  define  its.  duties  and  regulate  its  pay," 
approved  June  17,  1898,  is  hereby  repealed,  and  the  pay,  allowances,  and 
emoluments  of  the  enlisted  men  of  the  Hospital  Corps  shall  be  the  same  as  are 
now,  or  may  hereafter  be,  allowed  for  respective  corresponding  ratings,  except 
the  rating  of  turret  captain  of  the  first  class  in  the  seaman  branch  of  the  Navy : 
Provided,  That  the  pay  of  the  rating  of  the  chief  pharmacist's  mate  shall  be 
the  same  as  that  now  allowed  for  the  existing  rating  of  hospital  steward.  (The 
pay  of  chief  pharmacist's  mates  shall  be  $60  a  month ;  the  pay  of  pharmacist's 
mates,  first  class,  $40  a  month ;  the  pay  of  pharmacist's  mates,  second  class,  $35 
a  month ;  the  pay  of  pharmacist's  mates,  third  class,  $30  a  month ;  the  pay  of 
hospital  apprentices,  first  class,  $24  a  month ;  the  pay  of  hospital  apprentices, 
second  class,  $19  a  month.) 

404.  All  benefits  derived  from  existing  laws  or  that  may  hereafter  be  allowed 
by  law  to  other  warrant  officers  or  enlisted  men  in  the  Navy  shall  be  allowed 
in  the  same  manner  to  the  warrant  oflicers  or  enlisted  men  in  the  Hospital 
Corps  of  the  Navy. 

405.  The  Secretary  of  the  Navy  is  hereby  empowered  to  limit  and  fix  the 
numbers  in  the  various  ratings. 

31 


32  MANUAL   FOR    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY. 

40B.  Tlio  p.iy  of  enlistod  mon  of  tlip  Hospital  Corps  shall  be  tho  sanio  as  that 
provided  for  tho  corrcspondini;  rnfiiiirs  of  the  seaman  branch  or  other  staff 
corps  of  tlio  Navy.      (Act  May  13.  1908.) 

407.  Tlio  rrosi<lent  may  hereafter,  from  tinie  to  time,  appoint  as  many 
ph.uMoacists  as  may  be  deemed  necessiiry.  from  the  rating  of  chief  pharmacist's 
mate,  subject  to  such  moral,  physical,  and  professional  examinations  and  re- 
(luirements  as  to  length  of  service  as  the  Secretary  of  the  Navy  may  prescribe: 
Provided,  That  the  pbarmacisls  now  in  the  Hospital  Corps  of  the  United  States 
Navy  or  hereafter  appointed  therein  in  accordance  with  the  provisions  of  this 
act  shall  have  the  same  rank,  pay,  and. allowances  as  are  now  or  may  hereafter 
be  allowed  other  warrant  otiicers. 

Pharmacists  shall,  after  six  years  from  the  date  of  warrant,  be  commissioned 
chief  pliarmacists  after  passing  satisfactorily  such  examinations  as  the  Secre- 
tary of  the  Navy  may  prescribe,  and  shall,  when  so  commissioned,  have  the 
same  rank,  pa  v.  and  allowances  as  now  or  may  hereafter  be  allowed  other  com- 
missioned warrant  oflicers :  Provided.  That  the  pharmacists  at  present  in  the 
service  who  have  served  or  may  hereafter  serve  six  or  more  years  in  that 
grade  shall  1)6  eligible  for  promotion  to  the  grade  of  chief  pharmacist  upon 
satisfactorilv  passing  the  examinations  provided  for  in  this  act. 

408.  Officers  and  enlisted  men  of  the  Medical  Department  of  the  Navy,  serv- 
ing with  a  body  of  marines  detached  for  service  with  the  Army  in  accordance 
with  the  provisions  of  section  1621  of  (he  Revised  Statutes,  .shall,  while  .so 
serving,  be  subject  to  the  rules  and  articles  of  war  prescribed  for  the  govern- 
ment of  the  Army  in  the  same  manner  as  the  officers  and  men  of  the  Marine 
Corps  while  so  serving.  _  (Act  of  Aug.  29,  1916.) 

Section  2.— CiBcrLARS  RELATiifG  to  Enlistment  and  Promotion  in  the 
HospiTAi.  Corps.     (Enlisted  Force.) 

411.  Circular  relating  to  the  enlistment  of  men  for  the  United  States  Navy. 

(Yearly  by  Bur.  Nav.)  _  ,.  .  .     .u    tt       .*  i 

412  Circular  for  the  information  of  per.sons  desiring  to  enlist  in  the  Hospital 
Corp.s*  United  States  Navy.     (N.  M.  S.  127624,  Jan.  1917.) 

413.  Circular  for  the  information  of  commanders  in  chief  and  commanding 

officers.     (N.  Nav.  Sp.)  .     ,  ^.  .      x.       ,  „ 

414.  Circular  relating  to  enrolluient  in  United  States  Naval  Reserve  l-orce  as 
Ho.spital  Corpsman.     (N.  Nav.  373.)  .        ,  ^  ^ 

415.  Circular  relating  to  enrollment  in  United  States  Naval  Reserve  Force  as 
pharmacist.     (N.  Nav.  374.) 

Section   3.— Navy   REGVLATiOiNs   and  Naval  T.nstkuctions   Relating  to  the 
,  •  •  Hospital  Corps. 

!>in:  :       ^  .     ■  • 

421.  Duties   of   Bureau   of   Medicine   and    Surgery   in   connection    with    the 

Hospi'tal  Corps.     R  333.  ^  ^      '  ,         .^  ,   ■   ■        ♦      f»,„ 

422.  Not   to   perform    military   duties   other   than    those    pertaining    to    the 

Medical  Department.     R  1540.  .     ,.  .  .  ,         .    ^.        Toion/ii 

423.  To  constitute  a  part  of  surgeon  s  division  on  board  ship.     I  21.>0  (1). 

424.  Instruction  of  Hospital  Corp.s.     R  2901    (1)  ;  1  2642  (1-5). 

425.  Detail  and  duties  on  board  hospital  ships.     R  2911. 

426.  Disciiiline  aboard  liospital  ships.     R  2919  (1). 

427.  Qualifications  for  enlistment.     R  3.'')2.">   (1)    (12-13). 

428    Method  of  making  .service  records  of  the  Hosjiital  Corps.    R  3.)44  (8)  e. 
42!).  i'romotion  in  Hosi.ital  (^oips.    R  3317  (1)  ;  R  3.-r.l  (7  8)  ;  R  35.'i3  (1). 
4,10.  Di<harge  of  enlisted  men  of  Hospital  Corj)s.    R  3601  (9). 

451.  Not  to  be  discharged  until  stores  under  their  care  have  been  accounted 
for.     R  36or).  ^      ,.    ^^.,, 

452.  Fay  of  Hospital  Cori)S  (enlisted  force).     R    4427. 
433.  Duties  of  Hosiiital  Corps.     I  3252. 


MANUAL   FOE   THE   MEDICAL  DEPARTMENT,  U.   S.    NAVY.  33 

484.  Financial  dealings  with  patients  i)rohibited.  I  32G0. 

435.  Hospital  and  anihnlance  service.     I  8261. 

48(».  Responsibility  for  care  of  stores.     K  3402;  II  3605. 

437.  Classitication  and  precedence.     R  1026. 

438.  Drill  Book  for  the  Hospital  Corps  (autliorized).     I  602  (6). 

■■■  Section  4. — Chief  Pharmacists   (Commissioned  Warrant  Officebs)  and 
Pharmacists  (Warrant  Officers.) 

441.  Rank,  precedence,  and  classification  ofi  pharmacists  and  chief  pharma- 
cists. R  1013  (1-5). 

442.  Qualifications  and  appointment.     R  3317  (1-2). 

443.  Duties  aboard  ship.     R  3236. 

444.  Duties  of  pharmacists  and  chief  pharmacists.    I  2351 ;  I  2352. 

^..4^5.  Duties  in  hospitals  as  commissary.     (Bureau's  letter  No.  1217M).  ,.  ,  .h 

■>.-iti;f  hrij. 
.fo    ...:■  Section  5. — Chief  Phabmacist's  Mates.  ,.  ,i   s-'l 

)^'';^51.  Enlistment  as  chief  pharmacist's  ma,tes.    R:3523  (1)  ;  R  3525  (12-l3l.'ij'.'.'' 

'452.  Permanent  appointment.     R  35.53. 

453.  Marines  not  assigned  as  chief  pharmacist's  mates.    I  3641. 

454.  Care  of  stores      R  3402   (1-3). 

455.  Instruction  in  first-aid,  etc.,  of  Hospital  Corps.    I  2642. 

Section  6. — Pharmacist's  Mates,  First,  Second,  and  Third  Class  ;  Hospital 
Apprentices,  First  and  Second  Class. 

461.  Rank    and   precedence.     R   1026. 

462.  Enlistment,  requirements  and  authority  for.     R  3525   (12). 

463.  Examination  reports  and  promotions.    R  3525  (13)  ;  R  3.551  (8). 

464.  Appointment  as  petty  officer.     R  3552. 

472.  Hospital  apprentices,  second  class,  may  be  enlisted  without  specific 
authority  of  department.    R  3525  (12). 

473.  Duties  as  sick-bay  recorder.     I  2642   (3). 

474.  Hospital  corpsmen  detailed  to  assist  dental  surgeons.  (M.  &  S.  Letter 
No.  125300.) 

Section  7. — General  Information  Relating  to  the  Hospital  Corps. 

J  -481.  First  enlistments  in  the  Hospital  Corps  shall  be  made  only  in  the  rating 
of  hospital  apprentice,  second  class,  or  hospital  apprentice,  first'  class.  Appli- 
cants for  enlistment  in  the  rating  of  hospital  apprentice,  first  class,  must  obtain 
from  the  Bureau  of  Navigation,  Navy  Department,  permission  to  be  examined 
for  enlistment  in  this  rating.  ; 

Age  for  enlistment  as  hospital  apprentice,  second  class,  from  18  to  25  years; 
for  hospital  apprentice,  first  class,  fi-om  21  to  28  years. 

Upon  enlistment  in  either  of  these  ratings,  men  will  be  transferred  to  one  of 
the  Hospital  Corps  training  schools  for  instruction. 

Men  who  have  had  previous  training  in  nursing,  pharmacy,  etc.,  in  civil  life 
may  be  enlisted  in  the  rating  of  hospital  apprentice,  first  class,  provided  they 
obtain  permission  to  do  so  from  the  Bureau  of  Navigation. 

482.  A  person  desiring  to  enlist  as  a  hospital  apprentice,  second  class,  may 
be  examined,  and,  if  qualified,  enlisted  at  any  recruiting  station  or  navy  yard 
at  which  he  may  apply. 

483.  Enlisted  men  of  the  Navy  and  Marine  Corps  are  eligible  for  transfer  to 
the  Hospital  Corps.  Any  man  desiring  transfer  to  the  Hospital  Corps  should 
address  a  request  to  the  commanding  officer,  who  will  authorize  a  board  of 
medical  oflicers  to  conduct  the  necessary  examination.  A  .successful  candidate 
may  bo  appointed  after  his  report  of  examination  has  had  the  favorable  recom- 

98601°— 17 3  .     , , 


34  J\dA^'UAL   FOR    THE   MEDICAL  DEPARTMENT,   U.    S.    KAVY. 

ineiidation  of  tlic  Tiuroau  of  Medicine  anrl  Snrgery  approved  by  the  Bureaii  of 
Navijialion.  or  tho  ('(tinniiindant.  Alarine  Corps,  as  the  case  may  be.  Unlisted 
men  Tt.  the  Marine  Corps  desirinp  transfer  to  the  Hospital  Corps  must  first  rn- 
qiicst  discharjre  and  ajrree  to  enlist  for  a  four-year  period.  Krcept  in  enun- 
freiicv  a  marine  is  not  to  be  a.ssigned  to  duty  as  a  chief  pharmacist's  mate. 
(I    :UJ41     (2).) 

Men  in  other  l>ranohes  or  the  Marine  Corps  may  chanjre  rating  only  to  the 
ratings  of  1i(>v])ital  apprentice,  second  class,  or  hospital  :ii)j)rcntice.  first  class, 
proviiled  thoy  are  found  qunlifiod  by  examination  as  above  mentioned. 

484.  The  term  of  first  enlistment  in  the  Hospital  Corps  shall  be  for  four 
years.  ,  .  • 

485.  No  allowance  will  be  made  for  trrt^ellng  ana  other  exi>etrsefe  attend} iig 
the  examination  of  applicants.  ■      ' 

486.  Physical  and  professional  examination  by  one  or  more  medical  ofllcers 
shall  be  required  for  enlistment  and  promotion  in  each  of  the  several  grades 
and  rates. 

487.  Upon  the  enlistment,  fransf^r,  deatli.  desertion,  change  of  rating,  or 
discharge  of  the  enlisted  force  of  the  Ho.spitid  Corps,  the  medical  officer  of  the 
ship,  hospital,  or  station  will  immeditely  prepare  and  for>vard  through  the 
con\m:uKlinc  ofiicer  the  prescribed  mailing  card  for  the  information  of  the 
Bureau.  This  Information  is  required  in  order  that  timely  action  may  be 
taken  to  fill  any  vacancies  created. 

488.  In  all  cases  of  transfer  to  or  promotion  in  the  Hospital  Corps.  Bureau 
of  Navigation,  Form  No.  1-B  shall  be  forwarded  to  the  Bureau  of  N^xyigation 
and  Examination  Beport,  Plospital  Corps,  and  Changes  in  Hospital  Corps,  on 
prescribed  forms,  to  the  Bureau  of  Medicine  and  Surgery. 

489.  Members  of  the  Hospital  Corps  will,  in  addition  to  the  marks  now 
called  for  bv  the  Navy  Regulations,  have  entered  on  their  service  records,  marks 
in  (1)  proficiency  in  "rating;  (2)  nursing;  (3)  first-aid,  bandaging,  etc.  In  ad- 
dition, chief  pharmacist's  mates  an4l  pharmacist's  mates,  first  class,  will  be 
marked  in  (4)  pharmaceutical  ability,  and  (5)  clerical  ability.  The.se  marks 
will  be  entered  on  Bureau  Forms  Nos.  1  and  1-B  under  "  Professional  qualifica- 
tions "  in  columns  (a),  (b),  (c),  (rf),  and  (e),  respectively;  also  on  continuous- 
service  certificates. 

400.  Reports  of  examination:  In  all  cases  of  examination,  either  for  enlist- 
ment or  promoti(m,  or  for  permanent  appointment  as  chief  pharmacist's  mate, 
duplicate  reports  of  examination  .shall  be  made,  one  copy  to  be  forwarde<l  to 
the  Bureau  of  INIedicine  and  Surgery  and  one  to  the  conunanding  officer  of  the 
ship  or  station  where  the  man's  accounts  are  held.  It  is  particularly  desired 
that  these  reports  be  forwarded  to  the  bureau  uixm  original  enlistment.  In  the 
reports  of  examinations  of  pharmacist's  mate,  second  class,  to  pharmacist's 
mate,  first  class,  and  pharmacist's  mate,  first  class,  to  chief  pharmacist's  mate, 
mark's  in  ai)titude  (proficiency  in  rating)  and  marks  on  the  oral  and  practical 
examinations  only  will  be  inserted  in  the  report  by  the  board.  Other  marks  will 
be  assigned  after  review  of  the  candidate's  papers  in  the  bureaxi.  Upon  exam- 
ination for  a  i)ermanent  appointment  as  chief  pharmacist's  mate  the  examina- 
tion report,  Hosjiital  Corps,  with  marks  in  all  subjects  assigned  by  the  board 
and  the  candidate's  papers  (questions  and  answers),  nmst  be  forwarde«l  to  the 
Bureau  of  Medicine  and  Surgery  for  review.  With  the  examination  report 
there  should  be  forw.-irded  the  form  N.  M.  S.  42022  signed  by  the  medical  otlieer 
under  whom  the  candidate  has  served  and  a  copy  of  the  Form  1.  B.  In 
assigning  a  mark  for  aptitude  the  candidate's  aptitude  for  the  higher  rating 
should  l«'>  considered  by  the  Ix.ard  and  not  his  aptitude  in  the  present  rating. 

491.  Ktliciency  reports:  An  efficiency  report,  projierly  filled  in,  shall  be  for- 
warded, through  the  conunanding  officer,  in  every  case  of  transfer,  desertion,  or 
di><-hirge  of  an  enlisted  n)an  of  the  Hospital  (V>rps.  (Blank  forms  of  this 
report  are  furnished  by  the  Bureau  of  Medicine  and  Surgery. 

492.  In  order  to  avoid  confusion  the  term  "nurse"  shall  be  restricted  to 
members  of  the  Nurse  ('ori»s  (female)  and  not  applietl  to  members  of  the 
Ibispital  Corps. 


MANUAL   FOR   THE    MEDICAL  DEPARTMENT,   U.    S.    NAVY.  35 

Skction  8. — Chikf  Pir\RMAciSTS  Axo  Pharmacists. 

501.  Pharniarists  sliall,  after  six  years  from  the  date  of  warrant,  he  com- 
missioned  chief  pharmacists  after  passing  satisfactorily  such  examinations  as 
the  Secretary  of  the  Navy  may  prescrihe,  and  shall,  wlien  so  commissioned, 
have  the  same  rank,  pay,  and  allowances  as  now  or  may  hereafter  he  allowed 
other  commissioned  warrant  officers:  rroridcd,  That  the  pharmacists  at  present 
in  the  service  who  have  served  or  may  hereafter  serve  six  or  more  years  in 
that  grade  shall  he  eligible  for  promotion  to  the  grade  of  chief  pharmacist  upon 
satisfactorily  passing  the  examinations  provided  for  in  this  act.     (A'ct/of  Aagl 

29. 1016.)  '■  "■'  !v^';^; 

502.  The  Presidejit  may  hereaftei-,  from  time  to  time,  appoint  as  m';iny 
pharmacists  as  may  be  deemed  necessary  from  the  rating  of  chief  pharmaci.st's 
mate.  Chief  pharmacist's  mates  applying  for  appointment  must  bo  examinefj 
preliminarily  by  boards  of  oflicers  to  determine  their  physical  and  professiortyl 
fitness  to  appear  for  examination.  Subsequent  to  the  preliminary  examination 
they  shall  be  required  to  pass  a  satisfactory  examination  before  a  board  t'o  de- 
termine their  mental,  moral,  physical,  and  profes-sional  qualificrations  in  accord- 
ance with  the  provisions  of  R  3317  (1-2).  '/  '  .  ^     "'  ''^';  '  ',,■;,,,  '  ' 

503^.  A  candidate  for  appointment  as  pharmacist  'tn«^t''l^e'^'^;^\'1bgTra 
acting  or  periuanent  appointment  as  a  chief  pharmncisf's  mate,  have  served  at 
least  three  years  in  the  Navy  as  an  enlisted  man,  at  least  two  years  of  which 
service  must  have  been  performed  on  board  a  cruising  vessel,  preference  being 
given  to  men  who  have  been  honorably  discharged  and  whose  service  has  been 
continnous.  The  average  of  his  marks  taken  from  all  his  service  records  must 
he  not  less  than  85  per  cent.  No  person  shall  be  appointed  a  pharmacist  unles^ 
his  accumulated  previous  service  in  the  Army,  Navy,  and  IMarine  Corps; 
together  with  his  possible  future  service  prior  to  attaining  the  age  of  64  yearsi 
will  amount  to  at  least  30  years.     (See  Changes  No.  7,  Navy  Regulations.)       '/ 

504.  (a)  The  competitive  examination  of  chief  pharmacist's  mates  for  promo- 
tion to  phariuacist  shall  be  conducted  by  two  boards,  one  to  consist  of  three 
medical  ofric(irs,  or,  when  practicable,  two  medical  officers  and  a  pharmacist, 
appointed  on  the  station  on  which  the  candidate  may  be  serving,  another  to 
convene  at  Washington,  D.  C. 

(7))  The  local  board  will  examine  the  candidate  physically  and  in  practical 
work,  and  al.so  conduct  the  written  examination  on  questions  prepared  by  the 
Bureau  of  Medicine  and  Surgery,  but  will  not  assign  a  mark  for  the  latter.  The 
board  at  "Washington  will  mark  the  written  examination  and  the  service  record 
and  other  records  on  file  in  the  Bureau  of  Navigation.  The  marks  of  the  local 
board  and  those  of  the  board  at  Washington  will  then  be  combined  to  determine 
the  order  of  merit. 

(c)  The  mental  and  moral  examination  shall  include  the  previous  record  of 
the  candidate,  his  general  education,  and  proof  that  he  is  conversant  with  the 
clerical  duties  pertaining  to  the  Medical  Department  of  the  Navy  as  well  a^ 
the  management  of  sick  bays  and  ho.spital  wards.  His  professional  examination 
shall  be  oral,  written,  and  practical,  and  shall  include  pharmacy,  materia 
medica.  toxicology,  chemistry,  minor  surgery,  hygiene,  and  the  examination  of 
foods.  He  shall  be  required  to  demonstrate,  both  practically  and  theoretically, 
a  thorough  familiarity  with  the  current  jiharmacopoeia.  more  particularly  its 
pharmacy  and  materia  medica,  a  knowledge  of  chemistry  sufficient  to  enable 
him  to  make  qualitative  analyses,  uninvolved  volumetric  quantitative  estima- 
tions (for  the  latter  books  are  permitted),  and  urinalyses;  a  knowledge  of 
minor  operations,  applications  of  splints,  bandages,  etc.;  and  he  shall  be  re- 
quired to  show  that  he  is  well  informed  regarding  the  commissary  duty  at 
hospitals,  and,  further,  to  show  his  ability  in  the  inspection  of  foods,  such  as 
meats,  fi.sh,  poultry,  etc.,  and  the  determining  of  preservatives  and  adulterants 
in  milk,  butter,  jellies,  coffee,  sugar,  and  canned  vegetables  a,nd  fruits. 


36  MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

Section  0. — Chief  Pharmacist's  Mates. 

511.  (a)  Only  such  men  as  show  particular  fitness  for  the  duties  of  the 
rating  of  diiof  pharmacist's  mate  and  liave  the  force  of  character  necessary  to 
control  men  and  to  maintain  discipline  shall  be  recommended  for  permanent 
appointment.  A  report  of  insobriety  or  infraction  of  discipline  shall  disqualify 
any  man  for  examination  for  at  least  one  year  from  date  of  such  report. 
Physical  examination  is  not  required.  The  examination  will  follow  the  outline 
given  for  the  examination  for  promotion  to  the  rating  of  chief  pharmacists's 
mate,  acting  appointment,  except  tliat  more  advanced  questions  shall  be  given, 
and  include  a  knowledge  of  the  principal  movements  of  the  Hospital  Corps 
Drill  Book. 

(ft)  In  no  case  will  an  acting  appointment  as  chief  pharmacist's  mate  or 
pharmacist's  mate,  first  class,  be  issued  without  the  authority  of  the  Bureau  of 
Navigation.  Usually  an  acting  appointment  as  chief  pharmacist's  mate  or 
pharmacist's  mate,  first  class,  is  issued  only  upon  the  recommendation  of  a 
candidate  by  the  Bureau  of  Medicine  and  Surgery. 

(c)  Examinations  in  all  cases  (for  acting  or  permanent  appointment)  will 
bt>  practical,  oral,  and  written. 

r»12.  Men  must  serve  in  the  rating  of  chief  pharmacist's  mate,  acting  apix)int- 
meut,  for  at  least  12  months  before  they  are  eligible  for  advancement  to  chief 
pharmacist's  mate,  permanent  appointment. 

The  examinations. — Candidates  for  advancement  shall  be  examined  in  the 
following  subjects:  For  chief  pharmacist's  mate  (permanent  and  acting),  and 
pharmacist's  mate,  first  class — (1)  Aptitude  for  the  service  (shall  include  gen- 
eral  service  record).  (2)  General  education:  Arithmetic,  spelling,  writing 
(legibility  and  grammar),  geography,  and  history  of  the  United  States.  Ho.s- 
pital  training  and  a  knowledge  of  nursing  will  be  considered  to  the  advantage  of 
the  applicant  (3)  Anatomy  and  physiology:  The  skeleton,  joints,  and  muscles, 
digestive  apparatus,  blood  and  circulatory  system,  respiratory  and  excretory 
apparatus,  and  other  organs  of  the  body.  (4)  Minor  surgery  and  first-aid 
(including  surgical  and  operating-room  technic)  :  Emergencies  of  all  kinds,  con- 
tusions, wounds,  hemorrhages,  sprains,  dislocations,  fractures;  the  proper  con- 
duct of  surgical  technic,  preparation  for  operation  both  as  to  supplies  and 
appliances,  patient,  and  operator,  the  proper  conduction  of  minor  surgical  pro- 
ct^lures  within  the  duties  of  a  hospital  corpsman,  attendance  upon  larger  opera- 
tions in  the  operating  room  w'ith  Uie  surgeon,  care  of  and  conduct  within  the 
oi)erating  room,  etc. ;  methods  of  sterilization;  removal  of  foreign  bodies  in 
eyes,  ears,  and  air  passages ;  treatment  of  effects  of  excessive  heat  and  cold, 
bites  of  poisonous  animals,  insensibility,  fits,  a.sphyxia  or  suffocation  ;  bandag- 
ing;  application  of  splints;  and  knowledge  of  the  Hospital  Corps  Drill  Book. 
(5)  Nursing  and  materia  medica:  Practical  and  theoretical,  including  ward 
management,  beds  and  bed  making,  baths,  treatment  other  than  by  mouth, 
external  applications,  temperature,  pulse,  respiration,  symptoms  and  clinical 
records,  names  and  uses  of  instruments  and  appliances,  medical  and  surgical 
nursing,  including  preparation  of  patient  for  operation.  Therapeutic  classifica- 
tion of  drugs  of  the  United  States  Pharmacopoeia,  their  common,  botanical,  and 
oflicial  names,  parts  used,  doses  and  active  principles,  toxic  doses,  poisonous 
syiupliims,  and  antidotes.  (6)  Elementary  hygiene  and  sanitation  (general 
and  field):  Water,  air,  ventilation,  heating  and  lighting  of  wards,  etc.;  dis- 
posal of  wastes;  disinfection  and  disinfectants;  sterilization,  handling  of 
infectious  diseases,  and  prevention  of  dlsea.se;  practical  duty  In  the  field. 
(7)  Diets  and  messing  f(»r  the  sl<'k ;  classes  of  food,  various  classes  of  diet,  diet 
for  special  diseases,  obtaining  and  preparation  of  food,  jtroper  service  of  diets  to 
patients.  (8)  Clerical  procedures  and  forms:  Knowledge  and  preparation  of 
bureau  forms,  tyitevvriting,  and  ability  to  fornnilate  tM|)les  an<l  charts.  (0) 
pjiarniacy  and  cheniistry :  Various  pharmaceutical  processes  employed  In  the 
manufacture  of  official  preparations,  relative  proportions  of  the  more  im- 
jjortant  drugs  entering  into  their  composition,  weights  and  measures,  specific 


MANUAL  FOR  THE    MEDICAL  DEPARTMENT,  U.    S.    NAVY.  37 

gravity,  etc.;  inoompatibilitles;  dieinical  symbols,  the  formulas  of  the  more 
important  chemicals,  with  tests  lor  identity  and  the  reactions  produced  by  their 
combination.  (10)  Sick-bay  and  ward  duties  and  management;  also  care  of 
property  and  records;  systematic  routine  and  provi.sion  for  iierforminjr  and 
accomplishing  the  various  duties  in  the  care  of  the  patient  and  the  ward  itself, 
systematic  detail  of  hospital  corpsmeu  and  assistants  to  their  duties,  care  of  the 
storerooms  and  dispensary,  proper  stowage  and  safeguarding  of  property,  syste- 
matic methods  in  keeping  track  of  and  safeguarding  records,  etc.  (11)  Prac- 
tical work  in  all  subjects:  Submit  evidence  of  what  the  candidate  was  required 
to  do  in  his  practical  examination,  a  list  of  the  procedures  undertaken  with 
the  results  obtained ;  also  a  specimen  of  and  statement  as  to  the  proficiency  in 
typewriting  should  be  submitted. 

513.  Men  must  serve  in  the  rating  of  pharmacist's  mate,  first  class,  for  at 
least  18  months  before  they  are  eligible  for  examination  for  advancement  to 
the  rating  of  chief  pharmacist's  mate,  acting  appointment.  Advancement  to 
the  rating  of  chief  pharmacist's  mate,  acting  appointment,  however,  will  de- 
i>end  on  the  demands  of  the  service  for  chief  petty  officers.  A  pharmacist's 
mate,  first  class,  will  not  be  advancetl  to  the  rating  of  chief  petty  officer  during 
his  first  enlistment,  but  he  may  be  toward  the  completion  of  his  first  eidistment 
recommended  for  the  rating  of  chief  pharmacist's  mate,  acting  appointment, 
with  a  view  to  his  advancement  upon  reenlistment  should  he  be  found  qualified 
by  examination  and  his  services  be  required  in  that  rating,  depending  upon  the 
needs  of  the  service  for  chief  pharmacist's  mates.  The  examination  for  these 
three  ratings  may  be  given  without  the  department's  further  authority,  and 
shall  be  conducted  in  accordance  with  the  outline  given  in  paragraph  512,  before 
a  board  of  three  medical  officers,  or  two  medical  officers  and  a  pharmacist, 
detailed  from  a  station  ship,  or  sliips  other  than  that  upon  which  the  candidate 
is  serving,  if  practicable. 

514.  The  medical  officer  under  whom  the  candidate  is  then  serving  shall 
submit  a  statement  of  his  opinion  as  to  the  man's  qualifications  and  general 
fitness  for  the  rating  of  chief  pharmacist's  mate,  or  pharmacist's  mate,  first 
class.  This  statement  should  be  made  on  the  prescribed  form,  great  care 
being  taken  to  answer  questions  frankly  and  to  assign  marks  fair  to  the  man, 
but  with  a  view  to  the  subsequent  service  he  is  to  perform.  Upon  completion 
of  the  examination  the  written  proceedings,  without  corrections  or  assignment 
of  marks,  shall  be  forwarded  to  the  Bureau  of  Navigation,  the  board  only  to 
enter  marks  for  practical  work  and  the  candidate's  aptitude  for  the  higher 
rating,  on  the  form  Examination  Report,  Hospital  Corps.  The  papers  will  then 
be  passeil  upon  by  the  department,  and  if  the  candidate  is  found  qualified 
instructions  will  be  given  for  the  issue  of  an  appointment,  providing  his  con- 
duct has  been  satisfactory  in  the  interim. 

Section  10. — Pharmacist's  Mates,  First,  Second,  and  Third  Class,  and  Hos- 
pital Apprentices,  First  and  Second  Class. 

520.  For  advancement  to  pharmacist's  mate,  second  and  third  class,  and 
hospital  apprentice,  first  and  second  class,  the  medical  officer  should  examine 
the  candidate  in  accordance  with  the  following  outlines :  Should  the  candidate 
be  found  qualified  for  advancement  to  the  rating  which  he  seeks  he  may  be 
issued  an  appointment  without  further  authority  from  the  bureau  (except  in 
ratings  of  pharmacist's  mate,  first  class,  and  cliief  pharmacist's  mate,  acting 
and  permanent). 

521.  Men  must  serve  in  the  rating  of  pharmacist's  mate,  second  class,  for  at 
least  12  months  before  being  eligible  for  advancement  to  pharmacist's  mate, 
first  class,  and  must  pass  the  examination  prescribed  in  paragraph  512. 

522.  Men  must  serve  in  the  rating  of  pharmacist's  mate,  third  class,  for  at 
least  12  months  before  they  are  eligible  for  advancement  to  the  next  higher 
rating.  Men  must  have  served  in  the  Hospital  Corps  for  at  least  24  mouths 
continuously  before  being  advanced  to  the  rating  of  pharmacist's  mate,  second 
elas.s. 


38  MA>iUAL   FOR    THE    MEDICAL   DEPART A1KNT,U.    S.    NAVY. 

Applicants  for  proinotinii  to  llio  nitinfr  of  pliann.uists  mate,  sccuiitl  class, 
will  he  cxaiiiiiicil  in  llic  follou  iii}^  .siiltjccls :  (1)  AptiUiilc  for  the  service  (shall 
inclinle  ;,'cn('rMl  .service  re<'i»r(l).  {'2)  (Jeiier.il  education:  Ai'ithnictic,  spelliug, 
\vritin,Lr  (legibility  ami  grauiniar),  Kt'oKi'i'pl'.v.  and  liisLury  of  the  United  States. 
Hospital  traininfi  antl  a  knowledj^e  of  nursing  will  be  considered  to  the  advan- 
tage of  the  applicant.  (3)  Anatomy  and  jihysiolof^y  :  The  skeleton,  joints,  and 
muscles,  digestive  apparatus,  blood  and  circulatory  system,  respiratory  and 
excretory  apparatus,  and  other  organs  of  the  body.  (4)  Miuor  surgery  aud 
lirst-aid  (including  surgical  and  oi^erating-room  technic)  ;  euiergeucies  of  all 
kinds,  contusions,  wounds,  heniorrhages,  sprains,  dislocations,  fractures;  the 
proper  conduct  of  surgical  tochnic,  prepiiration  for  ()i)eration  both  as  to  supplies 
and  appliances,  patient  and  operator,  the  proper  conduction  of  minor  surgical 
procetlures  within  the  duties  of  a  hospital  corpsman,  attendance  upon  larger 
operations  in  the  opexating  room  with  tlie  surgeon,  care  of  and  conduct  within 
the  operating  room,  etc. ;  methods  of  sterilization ;  renjoval  of  foreign  bodies  in 
eyes,  ears,  and  air  passages;  treatment  of  elTects  of  excessive  heat  and  cold, 
bites  of  poisonous  animals,  insensibility,  fits,  asphyxia  or  suffocation  ;  bandaging; 
application  of  splints;  and  knowledge  of  the  Hospital  Corps  Drill  Book.  (5) 
Nursing  ajul  materia  medica :  Practical  and  theoretical,  including  ward  manage- 
ment, j)eds  and  bed  making,  baths,  treatment  other  than  by  mouth,  external 
applications,  temperature,  pulse,  respiration,  .symptoms  and  clinical  records, 
names  and  uses  of  instruments  and  appliances,  medical  and  surgical  nursing, 
including  preparation  of  patient  for  operation;  therai)eutic  classitication  of 
drugs  of  the  United  States  I'liarmacopoeia,  their  connuou,  botanical,  and  ollicial 
names,  parts  used,  doses  and  active  principles,  toxic  doses,  poisonous  symi)toius, 
and  antidote.s.  (6)  Elementary  hygiene  and  sanitation  (general  and  field)  : 
Water,  air,  ventilation,  heating  and  lighting  of  wards,  etc.;  disposal  of  wastes; 
disinfection  and  disinfectants,  sterilization,  handling  of  infectious  diseases  and 
prevention  of  disea.se;  practical  duty  in  the  field.  (7)  Diets  and  messing  for 
the  sick:  Classes  of  food,  various  clas.ses  of  diet,  diet  for  .special  diseases, 
obtaining  and  preparation  of  food,  proper  service  of  diets  to  patients.  (8) 
Clerical  proce<lures  and  forms:  Knowledge  and  preparation  of  bureiiu  forms, 
typewriting,  and  ability  to  formulate  tables  and  charts.  (9)  Pharmacy  and 
chemistry:  Various  pharmaceutical  proce.sses  employed  in  the  manufacture  of 
otiicial  preparations,  relative  proportions  of  the  more  important  driigs  entering 
into  their  com])ositiou,  weights  and  measures,  specitic  gravity,  etc.;  incom- 
patibilities; chemical  symbols;  the  formulas  of  the  more  important  chemicals, 
with  tests  for  identity  and  the  reactions  produced  by  their  combination. 

523.  .Men  nuist  serve  in  the  rating  of  ho.spital  apprentice,  lirst  class,  for  at 
least  six  months  before  they  are  eligible  to  take  the  examination  for  advance- 
ment to  pharmacist's  mate,  third  class.  No  man  will  be  promoted  to  the  rating 
of  pharmacist's  mate,  third  class,  unless  he  has  served  at  least  12  months  in  the 
Hospital  (vorps.  .   - 

Applicants  for  promotion  to  the  rating  of  pharmacist's  mate,  third  class,  will 
be  examined  in  the  following  subjects:  (1)  Aptitude  for  the  service  (shall 
Include  general  service  record).  (2)  General  cMlucation — arithmetic,  spelling, 
writing  (legibility  and  grammar),  geography,  and  history  of  the  United  Htatts* 
Hospital  training  and  a  knowledge  of  nursing  will  be  considered  to  the  advan- 
tage of  the  ai)plicant.  (3)  Anatomy  and  i)hysiol(jgy— the  skeleton,  joints,  and 
muscle.s,  di;iestive  apparatus,  blood  and  circulatory  system,  respiratory  and 
excretory  ajtparatus  and  other  organs  of  the  bo«ly.  (4)  Miuor  surgery  and 
lirst-aid  (including  surgical  and  operating-room  technic);  emergencies  of  all 
kinds,  contusions,  wounds,  hemorrliages,  sprains,  dislocations,  fractures;  the 
proper  conduct  of  surgical  technic,  itreparation  for  oiK-ration  both  as  to  sui>piies 
and  ap[)liunces  of  patient  and  ojH'rator,  the  proper  conduction  of  minor  surgi<iil 
procedures  wilhin  the  duties  of  a  hospilal  corjisman,  attendance  ui>on  larger 
operations  in  the  operating  room  with  the  surgeon,  care  of  and  conduct  williiu 
the  oi>erating  room,  etc.;  methods  of  sterilization;  removal  of  fc»reign  liodies  in 
eyes,  ears,  and  air  pas.sages ;  treatment  <»f  eflects  of  excessive  heat  aud,(x>m. 


MANUAL  FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.  39 

bites  of  poisonous  animals,  insensibility,  fits,  asphyxia  or  suflfocation ;  bandag- 
ing, application  of  splints,  and  knowledge  of  the  Hospital  Corp  Drill  Book. 
(5)  Nursing  and  materia  niedica — practical  and  theoretical,  including  ward 
management,  beds  and  beil  making,  baths,  treatment  other  than  by  mouth, 
external  applications,  temperature,  pulse,  respiration,  symptoms,  and  clinical 
records,  names  and  uses  of  instruments  and  appliances,  medical  and  surgical 
nursing,  including  preparation  of  patient  for  operation.  Therapeutic  classifica- 
tion of  drugs  of  the  United  States  Pharmacopoeia,  their  connnon,  botanical,  and 
olllcial  names,  parts  used,  doses  and  active  principles,  toxic  doses,  poisonous 
symptoms,  and  antidotes.  (6)  Elementary  hygiene  and  sanitation  (general  and 
tield) — water,  air,  ventilation,  heating  and  lighting  of  wards,  etc.;  disposal  of 
wastes;  disinfection  and  disinfectants,  sterilization,  handling  of  infectious  dis- 
ea.^e  and  prevention  of  disease ;  practical  duty  in  the  field. 

524.  (a)  On  first  enlistment  men  will  be  enlisted  in  the  ratings  of  hospital 
apprentice,  second  class,  and  hospital  apprentice,  first  class,  only.  Men  already 
eidisted  may  change  their  rating  to  one  of  these  ratings  only.  '  Men  who  have 
had  previous  training  in  nursing,  pharmacy,  etc.,  in  civil  life  may  be  enlisted 
in  the  rating  of  hospital  apprentice,  first  class,  provided  they  obtain  permission 
to  do  so  from  the  Bureau  of  Navigation. 

All  men  who  are  enlisted  as,  or  change  their  rating  during  the  first  half  of 
their  four-year  term  of  eidistment  to,  either  hospital  apprentice,  second  class, 
or  hospital  apprentice,  first  class,  will  be  transferred  to  the  nearest  Hospital 
Corps  training  school  for  instruction  immediately  upon  enlistment  or  change 
of  rating  and  without  further  authority  from  the  Bureau  of  Navigation. 

Men  who  have  enlisted  in  or  have  been  transferred  to  the  rating  of  hospital 
apprentice,  second  class,  and  have  been  detailed  to  one  of  the  Hospital  Corps 
training  schools  for  instruction,  must  serve  in  this  rating  until  the  course  of 
instruction  is  completed.  Upon  completion  of  the  course  and  graduation  from 
one  of  these  schools,  they  will  be  advanced  to  the  rating  of  hospital  apprentice^ 
first  clas.s. 

]Men  who  have  changed  their  rating  to  that  of  hospital  apprentice,  second 
class,  and  have  not  attended  a  Hospital  Corps  training  school,  must  serve  at 
least  six  months  in  this  rating  before  they  are  eligible  to  take  the  examination 
for  advancement  to  hospital  apprentice,  first  class. 

,  {b)  Applicants  for  enlistment  in  or  promotion  to  the  rating  of  hospital  ap- 
prentice, first  class,  will  be  examined  on  the  following  subjects:  (1)  Aptitude 
for  the  service  (shall  include  general  servi^-e  record).  (2)  General  education: 
Arithmetic,  spelling,  writing  (legibility  and  grammar),  geography,  and  history 
of  the  United  States.  Hospital  training  and  a  knowledge  of  nursing  will  be 
considered  to  the  advantage  of  the  applicant.  (3)  Anatomy  and  physiology: 
The  skeleton,  joints,  and  muscles,  digestive  apparatus,  blood  and  circulatory 
system,  i-espiratory  and  excretory  apparatus,  and  other  organs  of  the  body. 
(4)  Minor  surgery  and  first  aid  (including  surgical  and  operating  room 
techuic)  :  Emergencies  of  all  kinds,  contusions,  wounds,  hemorrhages,  sprains, 
dislocations,  fractures ;  the  proper  conduct  of  surgicy,l  technic,  preparation  for 
operation  both  as  to  supplies  and  appliances  of  patient  and  operator,  the  proper 
conduction  of  minor  surgical  procedures  within  the  duties  of  a  Hospital  Corps 
man,  attendance  upon  larger  operations  in  the  operating  room  with  the  surgeon, 
care  of  and  conduct  within  the  operating  room,  etc.,  methods  of  .sterilization ; 
removal  of  foreign  bodies  in  eyes,  ears,  and  air  passages ;  treatment  of  effects 
of  excessive  heat  and  cold,  bites  of  poisonous  auinials,  insensibility,  fits, 
asphyxia  or  .suffocation;  bandaging,  application  of  splints,  and  knowledge  of 
the  Hospital  Corps  Drill  Book. 

(c)  Applicants  for  enlistment  in  or  transfer  to  the  rating  of  hospital  ap- 
pi'entice,  second  class,  will  be  examined  on  the  following  subjects:  (1)  Apti- 
tude for  the  service  (shall  include  generar  service  record).  (2)  General  edu- 
cation: Arithmetic,  spelling,  writing  (legibility  and  grammar),  geography,  and 
history  of  the  United  States.  Hospital  training  and  a  knowledge  of  nursing 
will  be  of  advantage  to.  the  applicant.  *,,_, 


40  MANUAL  FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NA\^. 

i25.  rantli(l;ites  for  .•i(lv;iiiceuioiit  iiiiist  Mttaiu  the  marks  required  as  fol- 
lows: For  chief  plianuacist's  inato  (permuueiit  appointment),  3.5  ;  chief  phariiia- 
cist's  mate  (acting  appoiutmeut),  3;  pharmacist's  mate,  first  clas-s,  3;  all  other 
rate.s,  at  least  3. 

While  the  examinations  for  chief  pharmacist's  mate  (permanent  and  actinj.?) 
and  pharmacist's  male,  llrst  class,  are  similar,  a  coiiiparatively  !j;reater  knowi- 
e<lf,'e  and  familiarity  with  the  subjects  and  duties  should  be  exijectetl  for  the 
hif^her  rating.  : 

No  person  will  be  enlisted  or  retained  in  the  Hospital  Corps  who  is  addicted 
to  the  use  of  intoxicating  liquors  or  drugs,  or  who  at  any  time  shows  ■evidence 
of  intemperance  or  the  morbid  use  of  drugs. 

,No  ixTson  temperamentally  unfitted  for  this  class  of  work  will  be  ncceptetl. 

Before  advancement  to  any  higher  rating  a  Hospital  Corps  man  must  have 
served  satisfactorily  in  all  respects  for  the  refpiired  period  in  his  iwt^sent  rating. 

This  i^eriod,  however,  must  have  been  continuous  during  current  enlistnwnt, 
or  such  portions  of  the  time  in  each  of  two  enlistments  which  are  contiguous 
and  render  the  total  service  continuous  without  interruption  for  a  longer  period 
than  the  regular  four  mouths  allowed  between  discharge  and  reenlistment. 

He  must  have  received  during  this  period  an  average  mark  of  not  k^s  than 
3  in  proficiency  in  rating  and  obedience  and  4  in  sobriety,  and  have  a  record 
clear  of  infractions  of  discipline  for  the  past  year.  He  must  pass  the  required 
examination,  attaining  the  required  mark  for  the  rating. 

No  nuiu  shall  be  advanced  to  any  rating  unless  recommended  favorably 
by  the  medical  and  commanding  otficers. 

Medical  officers  are  expected  to  use  discretion  and  careful  judgment  in  recom- 
mending men  for  advancement  with  the  view  that  only  the  well  qualified  may 
be  advanced  to  the  various  rating.s.  It  is  not  desired  to  advance  unqualified 
men  because  of  their  length  of  service  only,  but  to  advance  those  who  are  fully 
qualified  and  who  have  a  satisfactory  knowledge  of  the  duties  of  the  various 
ratiugs  to  which  they  seek  advancement. 

In  all  cases  special  inquiry  must  be  made  relative  to  the  preliminary  educa- 
tion and  training  of  each  candidate,  and  the  spaces  pre.'^cribed  on  the  Examina- 
tion Heport,  Ho.spital  Corps,  United  States  Navy,  properly  filled  in.  It  Is 
desirwl  to  know  the  years  or  fractions  of  years  of  attendance  at  common 
schools,  high  schools,  academies,  training  schools  for  ntiraing,  pharmacy,  den- 
tistry, medicine,  or  other  training  or  experience. 

The  Bureau  of  Navigation  may  for  special  reasons  waive  or  change  time 
restrictions  placed  upon  advancement  in  rating.  No  requests  for  such  a  waiver 
or  change  should  be  submitted  in  any  individual  case.  Waiver  or  change  in 
time  restrictions  if  made  will  apply  to  u  designated  class  or  classes  of  the 
personnel.  ,     ;  . 

Section  11. — HosPiXAti  OdKPS,  Naval  MiriTiA. 

"SSI.  Examinatidns  for  thfe  Hospital' Corps,  Navfil  Militia,  wil)  be  h^ld'  1^' 
accordahce  with  instruct  ioTiS  contain^  lu  General  Order  No.  153, '.pag'e^^O/Sl,' 
G8,  69,  and  Appendices  A  and  B.  /    ^'"'ii   'I'w;    -•  y-  "f  •     ir>.n,  .  ,/, 

•""  .  '  '  ..iSftei'ibKr  l2.^Hosi'iTAii  CObpsI'  U.  S.  Naval  RE^iEii^T:'  Force. 

541.  Det.'iiled  Information  as  to  the  obligations,  emoluments,  and  necessary 
(lualilicalloiKS  for  enrollment  in  general  will  be  found  in  paraj^raph  131   (a-r). 

Phabmacist. 

G42.  Enrollment  of  persons  (not  previously  connected  with  the  Regular  Navy) 
us  pharmacists,  U.  S.  Naval  Reserv^;  Force,  .shall  be  made  In  the  Naval  C,)oast 
Defen.sc  Ueserve,  class  4. 

543.  A  candidate  for  enrollment  as  ti  pharmacist  lii  the  Naval  Reserve  Force 
must  enroll   in   the  provisional  enlisted   rating  of  chief  pharmacist's  mate  and 


MANUAL  FOB   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.  41 

must  perform  at  least  three  months'  active  duty  in  this  rating.  Subsequent 
thereto,  if  recommended  as  a  satisfactory  candidate  for  pliarmacist,  U.  S.  Naval 
Reserve  Force,  by  the  medical  and  conuuandinj;:  officers  \mder  whom  duty  has 
been  performed,  an  additional  continuous  period  of  at  least  three  months, 
active  duty,  for  further  instruction  and  training  must  be  served  at  a  naval 
hospital  or  on  board  a  hospital  ship. 

544.  Candidates  for  enrollment  must  apply  to  the  Chief  of  the  Bureau  of 
Medichie  and  Surgery  for  permission  to  be  examined  to  determine  their  quali- 
fications for  enrollment  in  the  provisional  enlisted  rating  of  chief  pharmacist's 
mate  with  a  view  to  subsequently  qualifying  for  the  grade  of  pharmacist,  U.  S. 
Naval  Reserve  Force. 

545.  Application  for  enrollment  must  be  made  in  the  handwriting  of  the 
applicant  according  to  the  following  form: 

(Rasidencc.y <>.:ni\:  > : 

__^__^____,    19— 

SiK :  I  request  permission  to  be  enrolled  in  the  provisional  rating  of  chief 
pharmacist's  mate,  in  the  Naval  Coast  Defense  Reserve,  class  4,  U.  S.  Naval 
Reserve  Force,  with  a  view  to  subsequent  examination  for  advancement  to 
the  grade  of  pharmacist  in  the  U.  S.  Naval  Reserve  Force,  the  examination  to 
be  held  subsequent  to  such  periods  of  active  service  under  instruction  and  train- 
ing as  the  Secretary  of  the  Navy  may  prescribe.* 

I  was  born  at ,  and  was years  of  age  on  the 

day  of ,  19 ;  and  am  a  citizen  of  the  United  States, 

residing  in ,  county  of , ,  and  State  of 

I  graduated  from  the School  of  Pharmacy  and  am  licensed 

to  practice  pharmacy  in  the  State  of .. 

I  forward  herewith  letters  testifying  to  my  moral  character,  habits,  citizen- 
ship, preliminary  education,  pharmaceutical  and  chemical  education,  license  to 
practice  pharmacy,  experience  in  hospital  organization,  management,  commis- 
sary, etc. 

..Very  respectfully,                                                          i;  nuii.';! 
,  ■".■  — ^ .^iit^^-d^^ 

(Name  in  full,. wvitten  legibly.) 
Chief  of  the  Bubeau  of  Medicine  and  Surgery, 

Navy  Department,  Washington,  D.  C. 

546.  The  above  application  must  be  accompanied  by  the  following  certificates: 

(a)  Letters  or  certificates  from  two  or  more  persons  of  good  repute,  testi- 
fying from  personal  knowledge  to  good  habits  and  moral  character. 

(b)  A  certificate  or  statement  from  some  ijerson  in  good  repute  that  the 
applicant  is  a  citizen  of  the  United  States.  In  case  applicant  is  a  naturalized 
citizen  of  the  United  States  his  naturalization  papers  or  other  satisfactory 
evidence  of  citizenship  must  be  submitted.  ■ 

(c)  Certificate  of  preliminary  education.  The  candidate  must  submit  a 
certificate  of  graduation  from  an  accepted  high  school  or  an  acceptable  equiv- 
alent. 

(d)  Certificate  of  pharmaceutical  education.  ThiS'Certiflcate  shoukl  give 
the  name  of  the  school  and  the  date  of  graduation,    i-.    ."i    ijoii' ■.aiiiiip  iw,,;    -..li 

(e)  A  certificate  of  license  to  practice  pharmacy.         '  ■'"   '•■'■■  '    i'       'a:; 
(/)  Certificates  to  the  effect  that  the  candidate  has  had  experience  in  hospital 

organization,  management,  and  commissary  and  special  aiucational  or  pro- 
fessional advantages,  signed  by  proper  authorities. 

547.  The  applicant  will  save  unnecessary  correspondence  if  he  will  make  sure 
when  submitting  him  application  that  the  qualifications  enumerated  above 
are  clearly  and  plainly  described  in  his  letters  or  certificates.      •'     .       ■  j      .    ' 

'When  directed,  the  applicant  should  substitute  the  words  '*  Volunteer  Naval  Reserve 
for  duty  in  the  Naval  Coast  Defense  Reserve,  class  4,  lliiited  States  Naval  Reserve  Force" 
for  the  words  "Naval  Coast  Defense  Reservp,  class  4,  IJ.  tS.  Naval  Reserve:  Force." 


42  MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

548.  After  passing  u|)i>ii  the  credoiitijils  of  tlii>  rjimrulate.  the  Hnrcaii  of 
Medifino  and  Sur^^ery  will  issue  u  permit  to  the  candidate,  eflective  for  a 
stated  period,  to  apj»ear  hefoie  one  or  nioie  medical  examiners  designated  by 
the  bureau  via  tiie  commandant  or  commandinti  otficer,  for  his  provisional 
physical  and  professioinil  examination.  The  i)ermit  will  direct  the  candidate 
to  communicate  with  the  senior  medical  examiner  as  to  the  date  and  place  of 
examination.  An  eflort  will  be  made  to  select  the  i)hice  of  examination  as  near 
as  iM)ssiltle  to  the  place  of  residence  of  the  candidate. 

549.  When  a  candidate  i»re.sents  himself  for  examination  on  the  date  fixed 
by  tlie  senior  medical  examiner,  he  nmst  bring  with  him  the  testimonials  as  t-»» 
ciiaracter,  habits,  citizensliiii,  preliminary  education,  i)harmaceutical  educa- 
tion, license  to  practice  pharmacy,  and  letters  describing  professional  f|uali- 
lications  and  those  indicating  his  experience  in  ho.spital  organization,  manage- 
ment, and  coinmissary ;  those  forwarded  with  his  application  being  returned 
for  this  purpo.se. 

550.  The  examination  Is  conducted  in  the  following  order:  1.  Physical. 
2.  Profes.sional.  .      •        ' 

(a)  The  iihysical  examination  is  thorough  and  the  candidate  is  required  to 
certify  that  he  is  free  from  all  nlental,  physical,  and '  constitutional  defects. 
(See  "al.so  par.  2107.) 

Acuteness  of  vision.  12/20  for  each  eye  unaided  by  glasses  bnt  capable  of 
correction  by  aid  of  lenses  to  20/20,  is  obligatory.  Color  perception  nmst  be 
normal  and  the  teeth  good. 

If  the  candidate  is  found  to  Tie  physically  disqualified  the  exfimrnation  Is 
concluded  ;  but,  in  the  case  of  a  candidate  otherwise  desirable,  the  medical 
examiners  may  recommeml  that  minor  discjualitications  or  departures  from 
standard  be  waived  and  i)roceed  with  the  professional  exannnation,  subject  to 
final  approval  by  the  dei)artment.  If  found  to  be  physically  qualified  bis 
examination  is  continued  as  follows:  , 

(6)  Professi(»nal  examination. —  (1)  Letter  to  the  board  dsecribing  in  detail 
his  general  and  professional  education.  ; 

(2)  Examination  of  diplomas,  certificates  of  State  boards.  (Certificates  and 
letters  and  such  other  recommendations  bearing  upon  the  professional  quali- 
fications of  the  applicant  as  he  may  de.sire  to  subuut.  ,      ,^,,  ^.n,:  > 

(3)  Written  examination  as  pre.scribed  in  paragraph  512. 

(4)  Upon  completion  of  the  examination  the  written  proceedings,  without 
corrections  or  assignment  of  marks,  shall  be  forwarded  to  the  Bureau  of  Medi- 
cine and  Surgery  (Bureau  of  Navigation),  the  l>oard  only  to  enter  uuirks  for 
I)ractical  work  and  the  candidate's  aptitude  for  the  rating  on  the  form  Examl- 
nation  Ueport,  Hospital  ('orp.s.  The  papers  will  then  be  passed  upon  by  the 
bureau,  and  if  tlie  candidal e  is  found  qualified  the  Surgeon  (;eneral  will  reconi- 
mend  to  th<'  Bureau  of  Navigation  the  enrollment  of  the  candidate  in  the 
provisional  rating  of  chief  pharmacist's  mate,  United  States  Naval  Reserve 
Force.  ■.'■.(    ■    >    •   :'  ' 

551.  After  enrollment  In  the  ivrovlsional  enlisted  rating  of  chief  phannaclst'a 
mate  Is  accomplislii'<l  the  camli(hite  should  make  nspiest  to  the  I'.uri'au  of 
^Medicine  and  Surgery  for  assignment  to  active  duty  for  instruction  and  train- 
ing and  qualification  for  appoiutment  as  pharmacist.  Two  pei-lods  of  three 
monilis'  active  duty  in  tlu'  medical  department  are  required. 

552.  Tlie  first  i>eriod  must  be  served  in  the  i)rovisional  rating  of  chief 
pharmacist's  mate  and  may  be  served  in  one  period  or  in  i)eriods  (tf  not  less 
than  three  weeks  each  year  successively.  The  second  jteriiKl  must  be  one  of 
continuous  service  for  three  months'  active  duty  at  a  naval  hospital  or  on  board 
u   lios]iital   ship. 

553.  Subscipient  to  the  first  period,  shouUl  the  candidate  be  reconmiended 
as  a  satisfactory  candidate  for  pharmacist.  UniU'd  States  Xaval  Reserve  Force, 
and  ftir  further  instruction  and  training  by  the  medical  and  connn.-inding  otfu^TS 
under  whom  duty  has  been  performed,  he  should  again  ai)ply  to  the  I'.ureau  of 
Medicine  ami  Suigery  for  assignment  to  tluty,  the  ai)pli<'atiou  to  accomi)any  the 


MANUAL   FOR    THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY.  43 

letter  of  reconinuMidutioa  submittod  by  the  medicul  and  coinuiandiuj,'  ofllfers. 
Upon  receipt  of  his  applieution  lie  may  be  given  an  oj)pui-lunlly  to  serve  aa 
additional  continuous  period  of  at  least  three  months'  active  duty  for  further 
instruction  and  training-  at  a  naval  hosi)ital  or  on  board  a  hospital  ship.  At 
the  end  of  the  second  period  of  active  duty  if  he  so  requests  and  a  vacancy 
exists  the  candidate  may  appear  for  final  examination  to  determine  his  quali- 
ficatious  for  appointmeut  as  a  pharmacist.  United  States  Naval  Reserve  Force. 

554.  Upon  receipt  of  the  applicant's  request  for  final  examination  for  ap- 
pointment and  notice  from  the  commanding  officer  of  the  hospital  that  the  re-. 
quired  two  periods  of  service  under  instruction  and  training  have  been  com-, 
pleted  the  candidate  will  be  directed  to  appear  before  a  board  of  medical 
examiners  designated  by  the  bur^^u  fw"  jlais  physical.. ancl  ^t^of^ssipaafl  ,exajBi- 
nation.  ,      •   :.,i         ■  ;    ■<.  .      .    ..'■        '  ■  ■,     ■■■'■■  I  )^.  i 

555.  Confirmation  in  grade:  An  applicant  completing  the  active  service  re- 
quired, who  requests  permission  to  be  exnmined  for  appointment  as  pharma- 
cist. United  States  Naval  Reserve  Force,  may  be  authorized  to  ajtpear  for  ex- 
amination at  a  designated  place  before  a  statutory  board  apiwiuted  for  this 
purpose. 

(a)   The  physical  examination  is  that  described  in  paragraph  5;:)0  {a). 

(?>)  Professional  examination.— (1)  Letter  to  the  board  giving  a  brief  state- 
ment of  the  candidate's  experience  while  undergoing  instruction  and  training 
in  active  service. 

(2)  Examination  of  active  service  records. 

(3)  Professional  examination  as  prescribed  in  paragraph  504  (c). 

(4)  The  board  will  give  careful  consideration  to  composition  and  spelling 
as  shown  in  the  written  papers  submitted  by  the  candidate  and  through  his 
service  record. 

(5)  Seventy-five  per  cent  is  required  as  a  general  average. 

556.  Those  "chief  pharmacist's  mates  provisionally  enrolled  in  the  United 
States  Naval  Reserve  Force  who  have  been  found  duly  qualified  for  appoint- 
ment as  pharmacist,  United  States  Naval  Reserve  Force,  and  who  will  be 
within  the  age  limit  of  35  years  at  the  completion  of  the  examination,  will  be 
recommended  for  appointment  as  pharmacists,  United  States  Naval  Reserve 
B\)rce,  provided  they  have  been  found  qualified  by  the  examination  above. 

557.  A  member  of  the  United  States  Naval  Reserve  Force  may  transfer  to 
or  from  the  Volunteer  Naval  Reserve  upon  approval  of  the  Bureau  of  Naviga- 
tion of  his  request  to  this  effect. 

558.  No  allovvance  will  be  made  for  the  expenses  of  persons  appearing  for 
examination. 

Hospital  Apprentice.  Fibst  and  Second  Class. 

560.  A  candidate  for  enrollment  as  a  hospital  corpsman  is  first  examined  for 
enrollment  in  the  provisional  rating  of  hospital  apprentice,  second  class,  or 
hospital  apprentice,  first  class,  Naval  Coast  Defense  Reserve,  class  4,  United 
States  Naval  Reserve  Force.  Afterwards,  if  his  enrollment  is  accomplished, 
should  he  so  desire,  he  makes  request  for  active  duty  for  confirmation  in  rating, 
and  after  the  completion  of  a  mininnim  period  of  three  months'  active  service 
he  is  again  examined  for  confirmation  in  rating. 

561.  When  first  reporting  for  active  service  for  training  during  each  period 
of  enrollment  men  are  credited  with  a  clothing  gratuity  of  $30.  In  time  of  war 
or  national  emergency  he  is  credited  with  $60  less  the  amount  previously 
credited,  if  any,  during  the  current  enrollment. 

562.  Men  who  have. had  nursing,  first-aid,  medical,  pharmaceutical,  or  other 
allied  trainings,  such  as  students  at  medical,  dental,  or  pharmaceutical  colleges, 
attendants  or  nurses,  druggists'  clerks,  etc.,  who  are  citizens  of  the  United 
States,  between  the  ags  of  IS  and  28,  if  found  qualified,  may  be  examined  for 
enrollment  in  the  Naval  Coast  Defen.se  Re.serve,  class  4,  United  States  Naval 
Reserve  Force,  Hospital  Corps. 


44  MANUAL   FOR   THE    MEDICAL   DEPARTMENT,  U.    S.    NAVY. 

5G3.  The  oxjiininnticni  coiKlucteil  at  the  enrolling  ofTice  is  simple.  It  con- 
siists  i)f  a  physical  exaniinatioii,  followed  by  a  professional  exaiiiination  whifh  is 
exa<-tly  the  same  as  that  ;;iven  aitpli'anls  for  the  Kegular  Naval  Estahlisluiieiit, 
except  that  a  iHMinit  for  permission  to  he  exaniini'd  for  the  provisional  rate  of 
hospital  apprentice,  first  class,  is  not  required.  (See  paragraphs  2107  and  524 
(ft)  and  {(■).) 

564.  A  member  enrolled  who  desires  active  duty  for  the  purpose  of  instruc- 
tion and  training  may  make  api)lication  to  his  commanding  otlictT,  the  com- 
mandant of  the  naval  district  in  which  the  member  has  enrolled.  The  applica- 
tion may  be  in  person  or  by  letter  and  should  state  the  length  of  active  duty 
desired  and  the  approximate  dates  the  member  desires  to  accept  service. 

605.  Confirmation  in  rating:  When  the  member  has  served  the  minimum 
period  of  active  duty,  three  months,  he  may  be  examined  for  confirmation  in 
rating.  The  physical  and  professional  examinations  are  those  prescribed  in 
paragraph  5G3. 


CHAPTER  5. 


THE  NURSE  CORPS. 
Section  1. — I>aws  Relating  to  the  Nurse  Corps. 

601.  Establishment  of  the  Niirse  Corps.     (Act  of  May  13,  1908.) 

"The  Nurse  Corps  (female)  of  the  United  States  Navy  is  hereby  established, 
and  shall  consist  of  one  superintendent,  to  be  appointed  by  the  Secretary  of  the 
Navy,  who  shall  be  a  graduate  of  a  hospital  training  school  having  a  course  of 
instruction  of  not  less  than  two  years,  whose  term  of  office  may  be  terminated  at 
his  discretion,  and  of  as  many  chief  nurses,  nurses,  and  reserve  nurses  as  may 
be  needed :  Provided,  That  all  nurses  in  the  Nurse  Corps  shall  be  appointed  or 
removed  by  the  Surgeon  General  with  the  approval  of  the  Secretary  of  the 
Navy,  and  that  they  shall  be  graduates  of  hospital  traiiung  schools  having  a 
course  of  instruction  of  not  less  than  two  years.  The  appointment  of  superin- 
tendent, chief  nurses,  nurses,  and  reserve  nurses  shall  be  subject  to  an  examina- 
tion as  to  their  professional,  moral,  mental,  and  physical  fitness,  and  they  shall 
be  eligible  for  duty  at  naval  hospitals  and  on  board  of  hospital  and  ambulance 
ships  and  for  such  special  duty  as  may  be  deemed  necessary  by  the  Surgeon 
General  of  the  Navy.  Reserve  nurses  may  be  assigned  to  active  duty  when  the 
necessities  of  the  service  demand,  and  when  on  such  duty  shall  receive  the  pay 
and  allowances  of  nurses:  Provided,  That  they  shall  receive  no  compensation 
except  when  on  active  duty.  The  superintendent,  chief  nurses,  and  nurses  shall, 
respectively,  receive  the  same  pay,  allowances,  emoluments,  and  privileges  as 
are  now  or  may  hereafter  be  provided  by  or  in  pursuance  of  law  for  the  Nurse 
Corps  (female)  of  the  Array." 

602.  Ray  of  the  Nurse  Corps  (Army),  Army  appropriation  act:  Extract  from 
the  act  of  March  23.  1910,  making  appropriation  for  the  support  of  the  Army  for 
the  fiscal  year  ending  June  30,  1911,  providing  for  the  pay  of  the  Female  Nurse 
Corps  of  the  Army  : 

"  *  *  *  and  the  superintendent  and  members  of  the  Female  Nurse  Corps 
shall  hereafter  be  paLd  at  the  following  rates:  Superintendent  Nurse  Corp.s, 
one  thousand  eight  hundred  dollars  per  annum ;  female  nurses,  fifty  dollars  per 
month  for  the  first  period  of  three  years'  service;  fifty-five  dollars  per  month 
for  the  second  period  of  three  years'  service;  sixty  dollars  per  month  for  the 
third  period  of  three  years'  service ;  and  sixty-five  dollars  per  month  after  nine 
years'  service  in  said  Nurse  Corps;  and  all  female  nurses  shall  here^ifter  be 
entitled,  in  addition  to  the  rates  of  pay  as  herein  provided,  to  ten  dollans  per 
month  when  serving  beyond  the  limits  of  the  United  States  comprising  the 
Union  and  Territories  of  the  United  States  contiguous  thereto  (except  Porto 
Rico  and  Hawaii),  and  to  cumulative  leave  of  absence  with  pay  at  the  rate 
of  thirty  days  for  each  calendar  year  of  service  in  said  corps ;  and  when  serving 
as  chief  nurses  their  pay  may  be  increased  by  authority  of  the  Secretary  of 
War,  such  increase  not  to  exceed  thirty  dollars  per  month;  and  the  superin- 
tendent shall  be  entitled  to  the  same  allowances,  when  on  duty,  as  a  member 
of  the  Nurse  Corps." 

45 


46  MANUAL   FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

Section   2. — Navy    Regulations   and    Xavai,    Instructions    Relating    to   the 

Nurse  Corps. 

611.  Bureau  cliiirped  with  appointment,  removal,  administration,  and  in- 
struction of  the  Nurse  Corps.     R  183   (1-2)  ;  R  2JX)1   (1). 

612.  Suliject  to  authority  of  eonini:m<linj;  oflicer  of  liosi)ital  sliip.     R  2910  (1). 

613.  Composition  of  Nurse  Corps.     R  P..'>22  (1). 

614.  Retiuirements  for  appointment.     R  3;>22  (2). 

(See  also  circular  for  the  information  of  persons  desiring  to  enter  the  Nurse 
Corps,  N.  M.  S.  1155S3.) 

615.  Duties  of  superintendent  and  detail  of  nurses.    R  3022  (3). 

616.  Pa.v  and  allowances.     R  3322   (4)  :  R  4  428. 

617.  Authorit.v  of  nurses  on  duty.     R  3322  (5). 

618.  Commutation  of  quarters.     R  4r»14. 

619.  Allowance  of  fuel.     R  4515  (7). 

620.  Plaf-es  where  eligible  for  duty.     I  3201. 

621.  Reserve  nurses.     R  3322  (31. 

622.  See  also  Manual  for  the  Medical  Department,  U.  S.  Army.,  1911.  pars. 
4S-96-  Changes  No.  .3,  April  2(5;  l9l2!.  Manual  for  the  ^Mcdical.Dopar.tincnt,  y..S. 
Army,'  1911.  Army  Regulations.  1910.  arts.  743-750,  1136',  114S,  and  1^1}  ^n(^, 
Army  Transport  Service  Regulations,  190S,  arts.  14S-163. 

623.  Speci.nl  nurses  not  to  be  eitiploycd.    I  3231. 
(M.  &  S.  letter  No.  120r>7«.')  "   '      "     ','  ' 

624.  Trangl>6rt{ition  and  travelling  allbwances.    1123. 

'    Section,  3.— Duties  of  the  S^uterintkndbnt  of  the  Nukse  Corps. 

6.31.  The  superintendent  of  the  N'urse  Corps  will  he  appointed  hy  the  Sec- 
retary of  the  Navy  upon  rofommendation  by  the  Surgeon  General,  subject  to 
examination  as  to  professional,  moral,  mental,  and  physical  fitnes-s,  and  to  the  re- 
quirements.of  the  law  regarding  hospital  training.  The  appointment  may  he 
revoked  l>y  the  Secretary  of  the  Navy  upon  the  recommendation  of  the  Surgeon 
Ceneral.  A  request  for  permission  to  appear  for  examination  preliminary  to 
appointment  will  he  addre.ssed  to  the  Secretary  of  the  Navy  via  the  Surgerui 
General.     The  examinati(m  \vi1l  be  conducted  by  a  hoard  of  medical  ofhcers. 

Any  applicant  for  the  position  of  superintendent  will  be  required  to  present 
herself  in  Wa,shington,  D.  C.  The  requirements  for  examination  are,  in  general, 
as  hereinafter  prescribed  fbf  the  examination  of  candidates  for  appointment 
as  nurses.  -'  ,■ 

6.32.  The  s\iperintendent  for  the  Nurse  Corps  will  have  general  supervision 
of  the  corps  under  the  Bureau  of  Jledicine  and  Surgery.  By  authorized  in- 
spections and  from  information  contained  in  reports  and  returns,  the  superin- 
tendent will  keep  hej-.self  informed  of  tlie  condition,  number,  distribution,  c«mi- 
petency,  and  dates  of  termination  of  appointments  of  the  memliers  of  the  corps. 
She  will  conduct  the  correspondence  wifh  inirses'  training  schools  and  nurses' 
li.ssociations,  with  the  i<lea  of  obtaining  acceptable  and  qualified  nurses  for  the 
naval  service,  and  will  be  a  memlier  of  the  examining  l^oard  for  nurst^.  She 
will  Iiave  charge  of  all  rcniords  pertaining  to  the  corps,  and  is  rcsponsiiile  for  the 
fdin-  indexing,  and  care  of  the  individual  records  of  nurses.  Reports  and  rC; 
turn's  relating  to  the  Nurses  Corps  will  be  referred  to  lier  for  her  information, 
<-omment  or  recommendation.  She  will  imlorse  all  reconnnendations  for  pro- 
motion to  chief  nurse  and  prepare  the  questions  for  the  examination  of  nurses 
preliminary  to  promotion,  reconnnending  those  qualified  as  tlwMr  services  are 
reouired  Slie  will  make  recommendations  regarding  matters  of  discipluie, 
leave  resigu.ition.  ami  Hie  a(<ei.tance,  assignment,  transfer,  an<l  discharge  of 
nurse's  an.l  the  r(Klu<tion  cr  discliarge  of  cliief  nurses.  Slie  will  endeavor  to 
maintain  the  usefulness  of  the  corps  as  a  part  of  the  Medical  Department,  an. 
jiroy.ose  to  the  Surgeon  Ceneral  any  measures  for  tlie  promotion  of  morale  and 
efhciency. 


MANUAL   FOR.  THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.  47 

633.  Thp  superintendent  is  olifiil'le  for  such  other  duties  not  lioroin  noted  as 
may  be  assigned  her  by  the  Surgeon  General.     (Act  of  May  13,  1908.) 

vliui  jf.;ii--ii  .. i  (v.ij^  Section  4. — Appointment  of  Nurses. 


641.  Application  for  appoiutujent  in  the  Navy  Nqrse  Corps  should  be  made  to 
the  Surgeon  General,  Bureau  of  Mediciq?  and  Surgery,  who  will  furnish  the 
neces.sary  blanks  therefor.  -■-■'- 

642.  An  applicant  for  appointment  in  the  Nurse  Corps  must  be  unmarried 
and  a  citizen  of  the  United  States.  She  shall  have  graduated  from  a  reputable 
training  school  giving  a  thorough  professional  education  both  theoretical  and 
practical  and  requiring  a  residence  of  at  least  two  years  in  an  acceptable 
general  hospital  of  100  beds  or  more.  Applicants  not  meeting  these  require- 
ments may  have  their  names  placed  upon  the  eligible  list,  if  otherwise  qualified, 
upon  presenting  a  diploma  showing  that  they  have  successfully  completed  a 
three  months'  postgraduate  course,  or  upon  submitting  proof  and  satisfactory 
credentials  of  six  months'  continuous  experience  in  a  general  hospital. 

643.  Applicants  practicing  in  States  where  registration  of  nurses  is  obliga- 
tory must  give  satisfactory  evidence  of  such  regiS;tr,ation.  Applicants  from 
States  not  requiring  State  board  examination  will  he  required  to  prove  they 
are  eligible  for  membership  in  the  American  Nurses- Association. 

644.  The  qualifications  of  the  apitlicant  will  be  ascertained  by  means  of  a 
certificate  submitted  to  the  .superintendent  of  the  training  school  from  which 
the  applicant  graduated,  showing  the  date  of  graduation,  moral  and  professional 
qualifications  during  her  training,  at  the  date  of  graduation,  and  (so  far  as 
known)  at  the  time  of  the  application.  Other  evidences  of  fitness  as  may  be 
deemed  necessary  will  be  required. 

645.  The  professional  and  mental  examination  will  be  in  writing  and  will  be 
conducted  by  a  board  of  examiners  appointed  for  the  purpose.  The  examination 
ordinarily  will  take  the  form  of  shoi't  essays  on  practical,  professional  subjects. 
These  essays  must  be  original  in  presentation  of  subject  and  must  be  in  the 
handwriting  of  the  applicant. 

646.  The  physical  fitness  of  the  applicant  will  be  determined  by  an  examina- 
tion conducted,  if  practicable,  by  a  naval  surgeon.  Should  this  necessitate  an 
unreasonably  long  journey,  the  examination  may  be  conducted  by  a  reputable 
physician  located  near  the  home  of  the  applicant.  The  examination  will  follow 
the  outline  of  the  form  supplied  and  the  medical  examiner  will  not  give  his 
report  to  the  applicant,  but  will  send  the  report  direct  to  the  Bureau  of  Medi- 
cine and  Surgery.    The  contents  will  be  regarded  as  confidential. 

647.  The  names  of  applicants  who  have  fulfilled  the  prescribed  conditions  will 
be  placed  on  the  eligible  list  for  appointjnent  at  such  time  as  their  services 
are  required.  No  applicant  will  be  coDsidprpdjpligible  who  will  not  agree  to 
serve  for  three  years.  ,   ru,,:  ,  >-"iiif:  o 

Section   5.— Chief^  Nubses. 

661.  Chief  nurses  will  not  be  appointed  from  civil  life,  but  vacancies  will  be 
filled  by  promotion  from  the  grade  of  nurse.  Permanent  assignments  to  duty 
as  chief  nurse  are  made  only  by  the  Surgeon  General,  upon  the  recommendation 
of  the  superintendent.  Before  final  promotion  a  nurse  must  have  served  at  least 
one  year  in  the  Nurse  Corps  and  have  passed  the  prescribed  examination. 

662.  The  examination  of  a  nurse  for  promotion  will  be  conducted  at  the  sta- 
tion, under  the  direction  of  the  me<lical  officer,  questions  having  been  sub- 
mitted from  the  bureau.  Upon  completion  of  examination  the  papers  will  be 
forwarded  without  assigning  marks  to  the  Bureau  of  Medicine  and  Surgery 
for  final  action. 

663.  Should  two  or  more  nurses  be  examined  on  the  same  date,  any  existing 
vacancies  will  be  filled  in  the  order  of  merit,  as  determined  by  length  of  service, 
efliciency  reports,  and  tbe  result  of  examination.  When  such  examinations 
are  conducted  at  two  or  more  widely  separated  stations  about  the  same  time, 


48  MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

the  decision  ns  to  tho  orrliM-  of  appointmont  rande  by  the  bureau  will  depend 
also  upon  the  roquireincnts  of  the  service  nt  the  stations  concerned. 

664.  A  chief  nurse  holding  a  permanent  appointment,  whose  services  are  no 
longer  required  as  chief  nurse  may  be  diseharjjed  or  assiftned  to  regular  duty 
as  nurse,  as  she  may  elect.  If  discharged  she  may  placed  on  the  reserve  list 
under  the  conditions  prescribed  in  .section  4.  Service  as  chief  nurse  will  not 
necessarily  entitle  a  nurse  to  have  a  subsequent  assijii^iment  as  chief  nurse. 
When  a  chief  nur.se  is  assigned  to  rcRidar  duty  as  nurse,  her  appointment  as 
chief  nurse  will  be  officially  canceleil.  Such  cancellation  will  not  adversely 
affect  a  reappointment  which,  imder  certain  circumstances,  may  be  made 
without  examination  in  the  discretion  of  the  Surgeon  General. 

665.  At  station.^  where  more  than  two  nurses  are  serving,  or  when  a  vacancy 
exists,  one  may  be  assigned  temporarily  as  chief  nurse.  Such  temporary  assign- 
ment to  duty  as  chief  nurse  will  be  made  the  subject  of  a  special  report  to  the 
Surgeon  Geucral,  in  which  lier  manner  of  filling  the  position  will  be  stated. 

•      ■!;  r>.i  \H'     i  'U":    •  ■■'  • 

'"*''!■  "'^TyCTION   6. — -ASsrONMENTS   AND  TrANSFEBS. 

671.  (a)  Nurses  will  be  assign^ 'to  duty  by  direction  of  the  Surgeon  General, 
and  Ihoy  will  be  rcfpiired  to  serve  at  home  or  abroad.  Their  services  are  avail- 
able for  sick,  wounded,  and  disabled  officers,  enlisted  men,  and  other  patients 
in  naval  hospitals  and  for  such  special  duty  as  may  be  deemed  necessary  by 
the  Surgeon  General.  When  traveling  under  orders  by  land  or  sea,  they  will 
assist  in  the  care  of  sick  oflicers  and  enlisted  men  who  may  be  present  on  the 
same  conveyance,  such  services  being  rendered  under  the  direction  of  a  medical 
officer,  if  one  is  present,  and  report  for  such  service  shall  be  sent  to  the  Surgeon 
General  by  competent  authority. 

(5)  The  families  of  officers  and  enlisted  men  are  not  entitled  to  the  services 
of  Navy  nurses,  and  they  will  not  be  detailed  for  such  duty  except  with  the 
prior  approval  of  the  Surgeon  General.  Ati  emergency  requiring  such  services 
in  advance  of  approval  should  be  reported  to  the  Surgeon  General,  stating  all 
the  circumstances. 

672.  (a)  The  first  six  months  after  appointment  shall  be  regarded  as  a  pro- 
bationary period  to  obsetve  tlie  professional,  moral,  mental,  and  physical  fitness 
of  the  nurse  for  the  naval  service  in  connection  with  the  siiecial  instruction, 
duties,  and  adaptability  to  connnunity  environment  peculiar  to  the  Navy.         ,; 

(h)  Three  weeks  prior  to  the  expiration  of  the  probationary  period  fh6' 
bureau  will  forward  the  ])rescribed  form  for  a  supplementary  physical  exami- 
nation to  be  made  and  returned  to  the  Surgeon  General,  obserA-ing  the  require- 
ment of  confidential  coinnuinications. 

(c)  At  the  same  time  the  chief  nurse  shall  submit  a  special  efiiciency  report 
relative  to  general  fitness  and  aptitude,  considering  the  professional,  moral,  and 
mental  qualifications  of  the  nurse,  and  making  such  recommendation  as  may 
be  indicated  bv  the  report.  The  medi(,-al  officer  in  command  will  state  by 
indorsement  whether  or  not  he  concurs  in  the  opinions  expressed;  and  also 
will  niake  recommendation  as  to  whether  or  not  he  consi<lers  the  probationer 
qualified  for  retention  in  the  Navy  Nurse  Corps. 

(rf)  Failure  to  meet  the  physical  requirements  for  duty  in  any  climate  and 
inaptitude  for  the  service  will  determine  reconunendation  of  revocation  of 
appointment. 

((•)  The  bureau  will  Inform  the  probationer  concerning  the  requirements  of 
a,  h,  r,  and  (I  of  this  jiaragraph  prior  to  her  assignment  to  duty. 

673.  A  triur  of  duty  at  each  station  will  be  usually  not  less  than  two  years. 
When'  a.ssigned  to  hospital  ships  or  to  stations  involving  extensive  travel,  the 
tour  of  duty  will  be  accounted  two  years  at  least  from  date  of  orders. 

674.  When  nurses  are  reipiired  at  a  hospil:\l  <ir  other  station,  the  medical 
officer  in  command  will  make  ai>plicnti(.n  to  the  Surgeon  (general,  through 
official  channels,  stating  the  nujuber  requinnl  and  the  necessity.  A  surplus  of 
nurses  on  the  station  at  any  time  should  be  immediately  reported  to  the  Sur-' 


MANUAL  FOR  THE    MEDICAL  DEPARTMENT,   U.   S.    NAVY.  49 

geon  General  and,  on  a  foreign  station,  to  the  commandant  or  commander  in 
chief. 

675.  Nurses  will  not  be  transferred  without  the  authority  of  the  Surgeon 
General,  except  at  stations  beyond  the  continentiil  limits  of  the  United  States, 
where,  upon  the  recommendation  of  the  medical  officer,  transfers  may  be 
directed  by  the  commander  in  chief.  A  commander  in  chief  on  a  foreign  station 
may  direct  the  return  of  sui'plus  nurses  to  the  United  States.  Nurses  so  trans- 
ferred will  be  directed  to  report  immediately  upon  arrival  in  the  United  States 
to  the  medical  officer  in  command  of  the  naval  hospital  nearest  to  the  port  of 
arrival  The  nurses  will  be  placed  on  temporary  duty  awaiting  instructions 
from  the  Surgeon  General.  Such  transfer  of  nurses  will  be  reported  at  once 
to  the  Surgeon  General,  with  a  statement  of  the  circumstances. 

676.  Nurses  in  complying  with  orders  involving  a  change  of  station  will  be 
governed  bj  article  702,  Naval  Instructions,  affecting  officers  in  like  circum- 

677.  A  nurse  will  not  leave  her  station  except  under  orders  or  when  granted 
leave  of  absence. 

Section  7. — Leave  of  Absence. 

681.  Members  of  the  Navy  Nurse  Corps  are  entitled  by  law  to  cumulative 
leave  of  absence,  with  pay,  at  the  rate  of  30  days  for  each  calendar  year  of 
service  in  the  corps,  to  be  reckoned  in  each  case  from  the  date  of  her  letter 
of  appointment.  Extra  leave  of  absence  with  pay  on  account  of  illness  can  not 
be  granted.     Leave  credit  will  not  be  allowed  for  periods  of  absence  without 

682.  (a) Leave  may  be  accumulated  at  the  rate  of  two  and  one-half  days  for 
each  month  of  completed  service,  including  periods  of  leave  with  pay  granted 
under  appointment.  The  accrued  amount  may  be  granted  whenever  the  ex- 
igencies of  the  service  permit.  Final  leave  to  the  amount  accumulated  and 
unusued  not  to  exceed  120  days  will  be  granted  prior  to  honorable  discharge. 

(&)  Upon  showing  good  and  sufficient  reason  for  such  request  leave  without 
pay  not  to  exceed  one  month  may  be  granted  when  the  requirements  of  the 
service  permit. 

683.  Leave' accruing  but  unused  under  one  appointment  will  not  be  credited 
irader  a  subsequent  appointment,  but  this  ruling  does  not  apply  to  a  continua- 
tion of  service  beyond  the  three-year  term. 

684.  (a)  Authority  to  grant  leave  of  absence  in  excess  of  10  days  rests  only 
with  the  Surgeon  General,  subject  to  modification  in  section  (d)  of  this 
paragraph. 

(b}  Requests  for  leave  of  absence  or  extension  thereof  shall  be  submitted 
by  the  nurse  in  writing,  using  the  prescribed  form,  and  shall  not  be  embodied 
in  other  requests.  Sufficient  time  shall  be  allowed  for  delay  and  transmission 
by  mail. 

(c)  Nurses  absent  over  leave  shall  be  automatically  on  status  of  leave  with- 
out pay  and  shall  be  reported  to  the  Surgeon  General  with  such  explanation 
as  may  be  submitted  for  definite  action. 

(d)  In  the  case  of  nurses  on  duty  at  hospitals  or  on  hospital  ships  beyond 
the  continental  limits  of  the  United  States  the  commanding  officer  may  grant 
leave  of  absence  as  provided  in  paragraph  681.  The  original  orders  granting 
such  leave  will  be  returned  to  the  nurse,  and  the  period  of  leave  and  by  whom 
granted  shall  be  reported  to  the  Surgeon  General. 

685.  (a)  When  accumulated  leave  of  absence  with  pay  is  granted  to  a  nurse 
on  service  in  Alaska  or  beyond  the  continental  limits  of  the  United  States  for 
the  purpose  of  coming  to  and  returning  from  the  United  States,  such  leave 
shall  be  calculated  between  the  date  she  reached  or  might  have  reached  the 
United  States  and  the  date  she  left  or  should  have  left  the  United  States  via 
the  usually  traveled  routes.  If  the  nurse's  return  to  service  abroad  is  not 
required,  the  termination  of  her  leave  shall  be  calculated  from  the  date  she 

98601°— 17 4 


50  MANUAL   FOR    THE    MEDICAL   DEPARTMENT,   TJ.    S.    NAVY. 

arrived  or  should  have  arrived  in  the  Unite<l  States  via  the  usunlly  traveled 
route. 

(b)  In  the  case  of  a  nurse  coming  to  the  United  States  from  or  soin?  from 
the  United  States  to  the  Philippine  Islands,  who  desires  to  make  the  journey 
by  a  route  other  than  the  customary  one  in  order  to  visit  foreign  countries 
on  leave  of  absence  while  on  route,  an  allowanct^  of  30  days,  as  on  status 
of  duty  without  right  to  reimbursement  of  traveling  expenses,  will  be  made 
in  addition  to  the  time  granted  as  for  leave  of  absence  to  cover  the  average 
amount  of  time  necesstiry  to  perform  the  journey  from  the  Philippine  Islands 
to  the  usual  port  of  arrival  in  the  United  States  or  from  said  port  to  the 
Philippine  Islands;  and  in  calculating  her  leave  the  said  period  of  30  days  for 
travel  shall  in  each  instance  be  excluded. 

6S6.  When  leave  with  pay  is  granted  a  nurse  on  service  In  the  Philippine  Is- 
lands to  be  absent  therefrom  other  than  to  c-ome  to  the  United  States,  such 
leave  shall  be  calculated  between  the  date  of  reaching  Manila  from  her  station 
and  the  date  of  leaving  Manila  in  returning  to  her  station.  (C.  M.  M.  D.  No.  3, 
Apr.  26,  1912.) 

687.  A  nurse  who  has  returned  to  the  Unitcid  States  on  leave  of  absence  or 
who  has  been  detached  from  her  station  and  granted  leave,  will  I'eport  in 
writing  to  the  Surgeon  General  at  least  one  week  prior  to  the  expiration  of 
said  lea^■e. 

688.  Permission  to  leave  the  United  States  must  be  obtained  from  the  Sec- 
retary of  the  Navj-,  and  requests  for  such  leave  should  be  submitted  with  due 
regard  for  time  required  for  this  official  procedure. 

089.  (o)  When  nurses  are  transferred,  statements  of  the  leave  with  pay  at 
that  station  shall  be  made  in  duplicate ;  one  copy  for  the  information  of  the  ]iay 
officer  who  is  carrying  the  accounts,  and  the  second  for  the  information  of  the 
pay  officer  who  will  take  up  the  accounts.  Final  leave  of  absence  prior  to 
discharge  will  be  computed  by  the  Bureau  of  Medicine  and  Surgery  for  the 
information  of  the  pay  officer  carrying  the  accounts  of  the  nurse. 

(b)  The  register  of  the  chief  nurse  should  be  kept  posted  to  date  showing  the 
amount  of  leave  granted  and  taken. 

Section  8. — Dischakges. 

691.  Nurses  are  entitled  to  discharge  at  the  expiration  of  the  three-year  term 
of  service  from  the  date  specified  in  the  letter  of  appointment,  except  that 
nurses  under  orders  to  proceed  home  to  await  discharge  will  not  be  discharged 
until  arrival  home,  or  until  they  shall  have  had  time  to  arrive  home  by  follow- 
ing the  usual  route  of  travel  with  ordinary  diligence,  or  as  provided  for  in 
paragraph  685  (o). 

692.  Nurses  may  be  discharged  at  any  time  prior  to  the  expii-atiou  of  their 
three-year  term  of  service:  (1)  Upon  their  services  being  no  longer  needed  ;  (2) 
on  account  of  physical  disability  interfering  with  active  service;  (3)  for  un.suit- 
ability  (as  outlined  in  paragrapli  072  (a),  inefficiency,  or  misconduct,  098  (b)  ; 
and  (4)  upon  their  own  application,  under  certain  conditions. 

693.  When  discharged  at  the  expiration  of  term,  the  following  indorsement 
will  be  placed  on  the  letter  of  appointment : 

Is  honorably  discharged  from  the  Navy  Nurse  Corps  by  reason  of 

the  expiration  of  the  terra  of  her  appointment. 

kiiirgcon  General,  U.  S.  N. 

694.  When  the  letter  of  apiwintment  is  not  available  for  the  above  indorse- 
ment, a  letter  of  discharge  of  equivalent  purport  will  be  furnished. 

696.  A  nurse  honorably  discharged  excei)t  upon  her  own  request  will  be  given 
orders  to  proceed  home  and  will  be  eiililled  to  transportation  and  necessary 


MANUAL   FOR   THE    MEDICAL  DEPAETMEKT,  U.    S.    NAVY.  51 

expenses,  as  hereinafter  provided.  Timely  action  will  be  taken  to  enable  her  to 
reach  her  home  before  the  beginning  of  her  final  leave  of  absence,  unless  she 
shall  prefer  to  take  her  final  leave  before  arriving  home,  in  which  event 
travel  orders  will  be  arranged  accordingly.  A  nurse  on  a  leave  status  is  not 
entitled  to  traveling  expenses. 

696.  An  application  for  discharge  prior  to  the  expiration  of  the  three-year 
term  may  be  made  by  letter  forwarded  through  official  channels  to  the  Surgeon 
Geaeral,  stating  the  reasons.  If  the  di.scharge  is  authorized,  the  following 
indorsement  is  placed  on  the  letter  of  appointment. 

— ~SSS"SS.~SS~~19^_ 

With  the  approval  of  the  Secretary  of  the  Navy,  the  resignation  of 

is  accepted. 

Surgeon  General,  U.  S.  N. 

This  indorsement  is  also  placed  on  the  letter  of  appointment  of  a  nurse  who 
applies  for  and  is  given  a  discharge  prior  to  the  completion  of  two  years  con- 
tinuous service  following  transfer  involving  extensive  travel. 

697.  Orders  to  proceed  home  will  not  be  issued  (1)  to  a  nurse  securing  dis- 
charge upon  her  own  application,  except  to  a  nurse  discharged  upon  her  own 
election  because  of  reduction  from  the  grade  of  chief  nurse;  (2)  or  before 
the  completion  of  two  years  of  continuous  service  involving  extensive  travel, 
or  to  a  nurse  who,  failing  to  apply  for  continuation  of  service  at  the  end  of 
the  three-year  period  in  which  she  is  serving,  is  discharged  on  or  about  the 
expiration  of  such  period ;  (3)  or  to  a  nurse  who  is  discharged  for  misconduct, 
see  698  (&). 

698.  (a)  A  recommendation  for  discharge  of  a  nurse  on  account  of  miscon- 
duct, 698  (ft)  will  be  forwarded  to  the  Surgeon  General.  A  full  report  of  the 
facts  must  be  submitted  after  a  caieful  investigation,  in  which  the  nurse  con- 
cerned shall  have  full  opportunity  to  be  heard  in  her  own  defense.  Should 
final  action  result  in  discharge,  the  indorsement  on  the  letter  of  appointment 
shall  read  "  for  misconduct."  If  stationed  outside  the  continental  limits  of 
the  United  States  a  nurse  discharged  for  misconduct  will  be  given  transporta- 
tion and  allowed  necessary  expenses  to  the  home  port  nearest  the  station. 

(&)  The  term  "misconduct"  includes  insubordination;  refusal  to  obey  orders 
from  proper  authorities ;  and  the  case  of  a  nurse  who  of  her  own  motion  quits 
or  abandons  the  service  in  advance  of  discharge  or  in  advance  of  detachment, 
from  station  as  per  orders ;  or  any  other  offense  against  military  authority. 

699.  A  nurse  ordered  home  for  discharge  will  at  once  report  by  letter  to  the 
Surgeon  General  the  date  and  hour  of  her  arrival  home. 

Section  9. — Repoets  and  Returns. 

701.  On  the  last  day  of  each  month,  or  as  soon  thereafter  as  may  be  pracy 
ticable,  a  return  of  nurses  will  be  submitted  to  the  Surgeon  General  by  the 
medical  officer  in  command  of  every  hospital  or  station  to  which  nurse's  are 
attached. 

702.  The  return  of  nurses  shall  give,  in  alphabetical  order,  the  names  of  all 
the  nurses  who  have  been  on  duty  during  the  month  or  any  part  of  a  month, 
and  all  changes  with  dates  which  have  taken  place  in  the  status  of  nurses  since 
the  preceding  return,  including  leaves  of  absence,  transfers,  and  days  of  illness, 

703.  (a)  On  the  last  day  of  the  month  the  medical  officer  in  command  of  the 
hospital,  or  under  whom  nurses  are  serving,  will  advise  the  pay  officer  concerned, 
on  form  prescribed  for  the  purpose,  the  number  of  nurses  on  duty  during  the 
month,  noting  number  of  days  each  nurse  (1)  subsisted  herself,  (2)  was  sub- 
sisted by  the  Government,  (3)  was  on  leave  with  or  without  pay.  The  medical 
officer  will  also  inform  the  pay  officer  regarding  the  assignment  of  chief  nurse 
or  acting  cliief  nurse. 


52  MANUAL   FOR    THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

(b)  On  the  last  day  of  the  quarter  the  quarterly  subsistence  report  shall  be 
rendered  in  triplicate  on  the  form  prescribed  for  the  purpose. 

704.  EtHciency  re[)orts  will  be  submitted  to  the  Surj^eon  General  on  the  1st 
day  of  January.  April,  July,  and  October.  When  a  nurse  is  transferretl.  a 
special  efficiency  report  will  be  sent  to  the  medical  ofhcer  of  her  new  station, 
to  be  appeniled  to  the  next  quarterly  report  submitted  to  the  Surgeon  General. 

When  a  nurse  is  discharged,  the  special  etticiency  report  shall  be  sent  direct 
to  the  Surgeon  General. 

705.  (o)  Efficiency  reports  will  be  prepared  by  the  chief  nurse.  The  medical 
officer  will  state  by  indorsement  thereon  whether  or  not  he  concurs  in  the 
opinions  expressed  and  the  marks  assigned.  In  each  case  the  report  of  the  nurse 
shall  indicate  the  character  of  her  professional  ability,  manner  and  performance 
of  duty,  conduct,  adaptability  for  the  service,  physical  fitness,  special  ability, 
and  correctness  of  uniform.  The  nature  of  special  details  and  dates  of  absence 
from  duty  shall  be  noted  and  reasons  for  unsatisfactory  rating  shall  be  fully 
stated.  The  chief  nurse  will  report  favorably  on  nurses  who  prove  themselves 
possessed  of  marked  executive  and  nursing  ability,  together  with  good  .iudgment 
and  tact,  recommending  that  such  nurses  be  placed  on  the  eligible  list  for  pro- 
motion to  chief  nurse.  The  special  efficiency  report  in  case  of  transfers  wilt 
note  such  recommendations  and  will  state  the  amount  of  night  duty  performed. 

(&)  Nurses  will  be  reiwrted  as  in  four  classes,  namely:  Class  1,  those  v.iio 
are  well  a(lai»ted  in  every  respect  for  the  Navy  work;  class  2,  those  who  are 
suitable  for  retention  in  the  Navy,  though  not  so  thoroughly  satisfactory  as 
those  in  class  1 :  class  3,  those  who  are  not  adapted  for  Navy  work  and  who 
are  recommended  for  discharge;  class  4.  those  who  have  been  recommendcnl  for 
immediate  discharge  on  account  of  misconduct  (689,  b). 

(c)  A  nurse  reported  under  class  3  shall  be  so  informed,  and  may  make  a 
statement  in  writing  with  regard  to  the  adverse  report  if  she  so  desires.  Should 
improvement  be  noted  during  the  quarter  indicating  a  higher  grade,  a  special 
efficiency  report  noting  this  fact  shall  be  sent  to  the  Surgeon  General.  Two 
reports  grading  a  nurse  3  will  be  considered  sufficient,  as  a  general  rule,  to 
indicate  inaptitude  for  the  service.  A  nurse  reported  in  class  4  shall  be  so 
informed,  and  a  full  report  shall  be  submitted  after  careful  investigation  of  the 
charges  of  misconduct.  The  nurse  shall  be  given  an  opportunity  to  be  heard 
in  her  own  defense,  and  any  written  exi^lanatory  statement  shall  be  forwarded 
with  this  report  (689,  b). 

(d)  The  medical  officer  in  command  will  report  on  the  efficiency  of  the  chief 
nurse,  specifying  in  detail  the  quality  of  the  service  rendered  by  her,  with  spe- 
cial reference  to  her  executive  ability,  good  judgment,  tact,  and  correctness  of 
uniform. 

(e)  Efficiency  reports  are  to  bo  regarded  as  confidential,  open  only  to  the 
chief  nurse,  executive  surgeon,  and  higher  authorities.  The  commanding  officer 
of  a  ho.spital  or  medical  officer  of  :i  station  to  which  nurses  may  be  attached  will 
therefore  see  that  these  reports  are  properly  safeguarded  and  transmitted  dii-ect 
to  the  Bureau  of  Medicine  and  Surgery  in  sealed  envelopes,  marked  in  the  lower 
left  corner  "  Confidential." 

706.  Illness  considered  to  be  of  a  confidential  nature,  if  affecting  the  efficiency 
of  a  nurse,  will,  when  occurring,  be  the  subject  of  a  .special  report  to  be  made 
privately  by  the  chief  nurse  to  the  commanding  officer  and  by  him  forwarded 
to  the  Surgeon  Gcnei'al. 

707.  Changes  in  the  status  of  nurses,  such  as  arrival,  departure,  leave  of 
absence,  orders,  etc.,  disability,  or  death  shall  be  reportet'.  immediately  to  the 
Surgeon  fJeiieral  by  means  of  information  slips  giving  in  each  instance  the  full 
name,  accurate  dates,  and  ju'riods. 

708.  {(i)  Members  of  the  -N'urse  Corps  shall  forwnid  all  communications  relat- 
ing to  official  matters  through  official  channels.     (I  .^.323;  5320.) 

(b)  The  chief  nurse,  or  acting  chief  n\irse.  shall  be  responsible  to  the  medical 
officer  in  command  for  the  prei>aration  of  the  reports,  returns,  .-ind  inforniniion 
slips  concendMg  the  nurses,  and  she  shall  be  directed  to  in<lorse  or  initial   all 


MANUAL  FOE   THE   MEDICAL  DEPARTMENT,  U.   S.    NAVY.  53 

official  papers  in  connection  with  tlie  nurses   requiring  the  signature  of  the 
medical  officer  in  command. 

(c)  The  register  of  the  chief  nurse  shall  be  kept  posted  to  date,  showing  all 
changes  in  status  of  nurses,  noting  the  grade  and  special  comments  on  efficiency 
reports,  and  shall  be  available  at  all  times  for  the  information  of  the  medical 
officer  in  command. 

Section  10. — Illness. 

711.  A  nurse  is  entitled  to  receive  medical  attendance  and  treatment  from 
medical  officers  of  the  Navy  when  ill.  Full  report  on  all  cases  will  be  entered 
on  prescribed  forms  (Health  Record,  Form  F)  as  supernumeraries. 

712.  Medical  attendance  and  treatment  will  usually  be  provided  for  at  the 
hospital  where  a  nurse  is  serving,  but  when  reported  as  desirable,  the  Surgeon 
General  may  recommend  transfer  to  another  naval  hospital  for  treatment. 

713.  When  treatment  by  a  specialist  is  required  for  a  nurse  on  duty,  the 
necessary  services  may  be  obtained,  as  provided  in  article  4534  (4)  Navy  Regu- 
lations. .  ,  T.        ..  , 

714.  When  medical  treatment,  including  medicine,  nursing,  and  hospital  care, 
is  required  by  a  nurse  on  duty  with  any  command  or  detachment,  and  can  not 
otherwise  be"  had.  the  commanding  officer  may  employ  the  necessary  civilian 
service  to  furnish  the  same,  and  just  accounts  therefor  will  be  paid  by  the 
Medical  Department.  When  the  nurse  who  requires  such  treatment  is  on  duty 
where  there  is  no  officer,  she  may  arrange  for  the  required  service.  When 
medical  treatment  is  required  by  the  superintendent  of  the  Nurse  Corps  while 
on  duty  and  can  not  otherwise  be  had  she  may  in  like  manner  procure  the  neces- 
sary civilian  service,  just  accounts  therefore  to  be  paid  by  the  Medical  Depart- 
ment.    (A.  R.,  1913.     Art.  74.     Sec.  1476.     Par.  4.) 

715.  Bills  contracted  by  a  nurse  for  medical  attendance  while  on  leave  or 
absent  without  leave  can  not  be  allowed. 

716.  A  nurse  will  not  be  discharged  for  disability  contracted  in  line  of  duty 
until  after  reasonable  time  has  been  allowed  for  treatment. 

717.  Health  records  (Form  H)  shall  be  kept  by  the  chief  nurse  except  when 
required  by  medical  officer  for  appropriate  entries.  It  shall  be  the  duty  of  the 
chief  nurse  to  transmit  the  health  records  direct  to  the  station  to  which  a  nurse 
is  transferred  or  to  the  bureau  upon  termination  of  service  of  nurse.  The 
envelope  containing  the  reqord  to  be  marked  in  lower  left  corner  "  Confidential." 

Section  11. — Pay  and  Allowances. 

721.  The  pay  of  the  Nurse  Corps  and  the  rent  of  quarters  for  the  use  of  its 
members  is  paid  from  the  appropriation  "  Pay  of  the  Navy  " ;  the  cost  of  sub- 
sistence from  the  appropriation  "  Provisions,  Navy  " ;  and  traveling  expenses 
from  the  appropriation  "  Pay,  miscellaneous." 

722.  In  calculating  logevity  pay  for  nurses,  credit  for  previous  service  m 
the  Nurse  Corps  of  the  Army  will  be  allowed.  Service  as  contract  nurse  prior 
to  the  establishment  of  the  Nurse  Corps  can  not  be  counted  in  this  connection. 
(Comptroller's  decision,  July  22,  1910.) 

723.  (a)  Nurses  are  entitled  to  $10  a  month  extra  pay  when  serving  beyond 
the  limits  of  the  United  States  comprising  the  Union  and  the  Territories  of  the 

-United  States  contiguous  thereto  (except  Porto  Rico  and  Hawaii),  said  addi- 
tional pay  to  commence  on  date  of  sailing  from  the  United  States  under  orders 
to  foreign  duty.     (Comptrollers'  decision,  Apr.  12,  1911.) 

"(h)  A  nurse  on  leave  of  absence  with  pay,  who,  having  been  attached  to  a 
station  beyond  the  continental  limits  of  the  United  States,  shall  elect  to  take 
her  leave  "of  absence  at  a  point  beyond  the  continental  limits  of  the  United 
States  without  returning  to  the  United  States,  shall  be  entitled  to  the  extra 
pay  of  $10  a  month  during  the  period  of  leave  with  pay.  (Comptroller's  deci- 
rjon,  Jan.  23,  1916.)"  i^,:; 


54  MANUAr.   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

724.  Pay  accounts  will  also  be  credited  under  conditions  outlined  and  pro- 
vided in  parajrniplis  T-Jl  and  753. 

725.  (o)  A  nurse  when  assigned  to  duty  as  chief  nurse  in  a  hospital  or  on  a 
hospital  sliip  or  ambulance  ship,  will  be  allowed  $30  per  month  in  adrlition  to 
her  pay  as  nurse. 

{b)  The  additional  pay  provided  above  for  chief  nurses  will  be  allowed  only 
after  reportinjr  for  duty  and  when  actually  serving  as  such;  when  on  leave  of 
absence  or  making  passage  between  stations,  they  will  draw  only  their  pay  as 
nurses. 

(c)  When  a  nurse  Is  temporarily  appointed  chief  nur.se,  to  act  in  the  absence 
of  the  regular  appointee,  on  leave  or  otherwise  absent,  during  such  assignment 
she  may  be  allowed  the  additional  pay  provided  for  chief  nurses. 

726.  Pay  officers  will  take  up  the  accounts  of  a  nurse  upon  presentation  of 
her  original  appointment  and  a  certified  copy  thereof  and  a  certified  copy  of  her 
orders,  with  all  indorsements  thereon. 

727.  Certified  copies  of  orders  assigning  nurses  to  duty  as  chief  nurses  will 
be  presented  to  the  pay  oflicer  concerned. 

728.  When  the  appointment  of  a  nurse  is  revoked,  when  she  is  discharged,  or 
when  she  is  transferred  from  one  hospital  or  station  to  another,  the  medical 
officer  in  command  or  under  whom  she  has  been  serving  shall  notify  the  pay 
officer  concerned. 

729.  When  transferred  to  another  hospital  or  station,  the  pay  officer  shall 
furnish  a  nurse  with  a  transfer  account  in  the  same  manner  as  for  officers  or 
enlisted  men  of  the  Navy,  showing  the  rate  of  pay  and  date,  inclusive,  to  which 
paid. 

730.  The  superintendent  shall  be  entitled  to  the  same  allowances,  when  on 
duty,  as  members  of  the  Nurse  Corps. 

731.  Nurses  will  be  checked  20  cents  per  mouth,  to  be  credited  to  the  naval 
hospital  fund,  as  in  the  case  of  officers  and  enlisted  men. 

732.  Sales  of  subsistence  stores  will  be  made  at  cost  price  for  cash,  and  will 
be  made  on  a  certificate  that  they  are  for  her  personal  use,  to  a  nurse  when 
stationed  within  a  military  post  or  serving  with  troops  in  the  field.  (A.  R., 
1913.    Art.  73.    Sec.  1239.) 

Section  12. — Subsistence. 

741.  (a)  For  each  day  a  nurse  is  subsisted  by  the  Government  the  account 
of  the  nurse  will  be  credited  for  commutation  of  rations  in  sundry  column  at 
the  rate  of  40  cents  per  day  and  will  be  checked  in  the  same  amount. 

(ft)  For  each  day  a  nurse  subsists  herself  she  will  be  credited  in  the  sundry 
column  with  40  cents. 

(c)  Nurses  on  detached  duty  in  a  city  or  town  or  at  a  station  where  subsist- 
ence is  not  furnished  by  the  Government  will  receive  commutation  of  rations  at 
the  rate  of  $1  per  day. 

742.  Nurses  on  leave  of  absence  with  pay  will  receive  commutation  of  rations 
at  the  rate  of  30  cents  per  day.  Army  Regulations,  Circular,  par.  1223,  .Tuly 
5,  1910.  ,    ■      ... 

Section  13. — Quabters. 

I  751.  (a)  When  on  detached  scr\  ice,  or  .-'.sslgued  to  special  duty  In  places 
,  jyhere  there  are  no  public  quarters  available,  Ihe  allowance  of  qu.Mrters  for  each 
member  of  the  Nurse  Corps,  is  fixed  at  (wo  rooms,  to  bo  jirovided  by  the  Quar- 
termaster Corps,  with  allowances  of  f\iv\  and  stoves  not  to  exceed  those  pre- 
scribed in  paragraph  1044,  and  of  light  not  lo  exited  the  quantities  prescribed 
In  paragraphs  1054  and  10r»7,  A.  R.  1913.  ,  ,.,'     , 

(b)  When  on  duty  in  hospitals,  or  where  'nur!?es'  buildings  Imve  been  pro- 
vided, such  quarters  as  may  be  available  will  be  provided  for  the  use  of 
members  f)f  the  Nurse  Corps,  in  which  ( ase  heat  and  light  will  be  supplied  as 
may   be  necessary    to   be   regulated    by    the   surgeon   and   commanding   officer. 


MANUAL   FOR   THE   ilEDICAL  DEPARTMENT,   U.    S.    NAVY.  65 

The  allowances  for  the  superintendent  of  the  Nurse  Corps  when  on  duty  are 
the  same  as  those  prescribed  for  members  of  the  Nurse  Corps.  (A.  R.  1913, 
■art.  73,  sec.  1045,  pars.  1  and  2.    R.  4514.) 

752.  (a)  When  practicable  the  allowance  of  quarters  provided  for  nurses  on 
duty  at  a  naval  hospital  will  include  one  dining  room,  one  kitchen,  one  sitting 
room  and  the  necessary  toilets  and  bathrooms  for  the  use  in  common  of  all  the 
nurses,  with  a  separate  bed  room  for  each  nurse  and  for  the  chief  nurse.  At 
hospitals  where  more  than  five  nurses  are  stationed,  an  office  and  a  separate 
bathroom  and  sitting  room  will  be  provided  for  the  chief  nurse. 

(ft)  The  bureau  will  supply  the  necessary  linen  and  furniture  for  quarters 
-of  nurses  on  duty  in  hospitals.    Linen  will  be  laundered  in  the  hospital  laundry. 

753.  As  authorized  by  the  urgent  deficiency  act  June  15,  1917,  nurses  of 
Navy  will  receive  same  allowance  as  nurses  of  Army  in  lieu  of  quarters,  when 
not  occupying  Government  quarters,  which  amount  will  be  credited  on  the  pay 
roll  upon  the  certificate  of  the  senior  medical  officer  at  the  hospital  or  station 
where  members  of  said  Nurse  Corps  may  be  serving  that  applications  for,  and 
no  assignment  of,  quarters  has  been  made  and  that  Government  quarters  are 
not  available. 

Section  14. — TBANsroRXAxioN  and  Traveling  Allowances. 

761.(0-)  Nurses  traveling  under  orders  are  entitled  at  public  expense  to  their 
own  transportation  and  to  traveling  allowances  and  transportation  of  baggage 
as  provided  in  accompanying  schedule. 

(b)  Cost  of  transportation  by  the  shortest  usually  traveled  route,  when 
transportation  in  kind  or  transportation  request  is  not  furnished. 

(c)  Actual  cost  of  baggage  transwer  as  required  by  necessities  of  the  journey ; 
receipt  to  be  furnished ;  baggage  limited  to  not  more  than  two  pieces. 

((?)  Cost  of  one  lower  berth  in  sleeping  car,  seat  in  pai-lor  car,  or  usual  state- 
room accommodations  on  boat,  when  extra  charge  is  made  therefor. 

(e)  Cost  of  meals,  including  tips,  not  to  exceed  .$4.50  per  day  while  en  route, 
when  meals  are  not  included  in  the  transportation  fare  paid. 

(/)  Cost  of  meals,  tips,  and  lodging  during  necessary  delays  en  route,  not  to 
exceed  $4.50  per  day. 

(g)  Cost  of  meals  and  lodging,  including  baths,  tips,  and  laundry  work,  not 
to  exceed  $4.50  per  day  while  on  duty  designated  in  orders  for  the  performance 
of  temporary  duty;  but  reimbursement  for  such  expenses  will  be  limited  to  $1 
per  day  after  the  first  30  days  at  any  one  place. 

(7i)  Excess  baggage,  not  to  exceed  100  pounds,  as  per  receipt. 

(i)  Street  car  fare,  or  under  exceptional  circumstances,  when  street  car  serv- 
ice is  not  available,  actual  cost  of  cab,  carriage,  or  taxi  hire.  When  charge  is 
made  for  cost  of  conveyance  other  than  street  car,  full  explantion  of  necessity 
therefore  must  be  made  and  approval  of  the  Secretary  of  the  Navy  obtained 
therefor. 

(;■)  When  travel  covers  less  than  a  full  day :  Single  meals  not  to  exceed  $1.25, 
and  tips  at  single  meals  not  to  exceed  15  cents  each. 

762.  (o)  When  transportation  in  kind  is  not  furnished,  and  transportatioji 
requests  can  not  be  procured,  the  nurse  may  pay  her  own  travel  fare  (which 
must  not  exceed  the  cost  of  a  first-class  limited  ticket  between  her  starting 
point  and  her  destination),  and  ask  for  reimbursement  in  her  expense  account 
in  accordance  with  the  following  section. 

(6)  Chief  nurses  and  nurses  taking  passage  on  a  Government  vessel  will  be 
furnished  meals  in  the  ward  room  (or  saloon)  mess. 

(c)  When  a  nurse  traveling  under  orders  incurs  expen.5es  for  which  she  is 
entitled  to  reimbursement,  upon  completion  of  the  travel  she  will  prepare  her 
accoimts  of  the  same  in  duplicate  on  the  prescribed  form  (S.  &  A.  Form  90). 

(d)  Upon  arrival  home  for  honorable  discharge  she  will  forward  a  complete 
and  detailed  account  of  her  expenses  with  a  certified  copy  of  her  discharge  to 
4;h,e. .Paymaster  General.        ,     .  „,r,  ^...„,^,y.i  „ ,/.,    ;.„    r...'ii;   ;,^i^uji:-.;r;i/ eci  v-sm 


56  MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

(e)  Transportation  requests  which  are  not  used  shall  be  returned  to  the  pay 
officer  who  issued  them.  If  transportation  requests  are  exchanged  for  ticiiets, 
which  as  a  whole  or  in  part  remain  unused,  said  ticketsor  portions  thereof  shall 
be  similarly  returned. 

(/)  Transportation  over  seas  will  be  by  Government  conveyance  when  prac- 
ticable. 

Section  15. — Uniforms. 

771.  The  uniform  and  badge  of  the  Navy  Nurse  Corps  will  be  according  to 
patterns  and  specifications  prescribed  by  and  on  file  in  the  Bureau  of  Medicine 
and  Surgery. 

772.  A  nurse  provides  her  own  uniform  which  may  be  procured  witliin  a 
period  of  six  months  after  she  reaches  her  station  of  duty.     Detailed  instruc- 

.jtions  on  the  .subject  will  be  supplied  by  the  chief  nurse. 

•      773.  The  uniform  will  be  worn  invariably  during  the  hours  of  duty.    Nurses 
not  in  uniform  will  not  be  allowed  in  the  wards. 

774.  Nurses'  uniforms  will  be  washed  in  the  hospital  laundry  when  a  laundry 
is  provided. 

Section  16. — Reserve  Nurses. 

781.  A  nurse  who  serves  faithfully  and  satisfactorily  for  at  least  six  months 
and  has  resigned  for  good  and  sufficient  reason  will  be  placed  on  the  reserve 
list,  if  she  so  desires. 

782.  A  reserve  nnrse  must  sign  an  agi'eement  to  enter  active  service  when- 
ever needed,  and  report  by  letter  her  residence  to  the  Surgeon  General  on  the 
1st  of  January  and  the  1st  of  July  of  each  year.  A  reserve  nurse  will  be  entitled 
to  wear  the  badge  of  the  Navy  Nurse  Corps,  but  not  entitled  to  pay  or  allowances 
except  when  on  active  duty. 

78.3.  When  called  into  active  service  a  reserve  nurse  will  be  subject  to  all 
established  rules  and  regulations  and  will  receive  the  pay  and  allowances  of 
nurses  of  the  active  list. 

784r.  A  nurse  will  be  dropped  from  the  reserve  list  upon  reaching  the  age  of 
45  years ;  or  if  she  ceases  f<jr  five  years  to  practice  her  profession ;  or  if  she 
becomes  permanently  incapacitated  by  ill  health ;  or  if  she  fails,  without  satis- 
factory reason,  to  respond  promptly  to  a  call  into  active  service;  or  if  .she  fails 
to  notify  the  Surgeon  General  of  any  change  in  her  permanent  address;  or  for 
other  good  and  sufficient  reasons;  but  a  nurse  shall  not  be  dropped  from  the 
reserve  list  without  due  notice  of  the  cause  for  such  action  and  an  opportunity 
to  reply  to  any  charges  which  may  be  made  against  her. 

Section  17. — Nurse  Corps,  United  States  Naval  Reserve  Force. 

790.  A  candidate  for  enrollment  as  nurse  is  first  examined  for  enrollment  In 
the  provisional  grade  of  nurse,  United  States  Naval  Reserve  Force.  After 
her  enrollment  is  accomplished,  should  she  so  desire,  she  may  make  request 
for  active  duty  for  confirmation  in  grade;  and  after  the  completion  of  a 
mininuiin  period  of  three  montlis'  active  service  she  is  again  examined  and. 
if  found  qualified,  is  confirmed  in  grade.  Legislation  establishing  the  United 
States  Naval  Reserve  Force  contains  in  .substance  matter  referable  to  enroll- 
ment of  luirscs,  as  follows: 

(a)  A  menil>er  must  be  a  citizen  of  the  United  States. 

(b)  A  member  obligates  herself  to  perform  and  may  he  ordered  to  active 
service  in  the  Navy  throughout  a  war,  or  during  the  existence  of  a  national 
enierg<nicy  declared  by  the  I'rcsident,  should  either  arise  (hn-iiig  her  term  of 
enrollment. 

(c)  A  member  enrolls  or  reeiirolls  for  a  term  of  fnur  years. 

(d)  In  time  of  peace,  and  when  no  national  emergency  exists,  a  menilier 
may  be  disdiarged   upon   her  own  retjuest,   upon   re'nihurslng  the  Govermnent 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.    S.    NAVY.  5? 

for  any  clothing  gratuity  tliat  may  have  been  furnished  during  her  current 
enrollment. 

(e)  A  member  is  required  to  talie  the  oath  of  allegiance  to  the  United  States. 

(/)  A  member  after  enrolling  may,  in  time  of  peace,  upon  her  own  request, 
be  assigned  active  duty  in  the  Navy  for  such  periods  of  instruction  and  training 
as  may  enable  her  to  qualify  for  and  be  confirmed  in  grade. 

(g)  For  confirmation  in  grade  a  member  must  serve  the  minimum  amount 
of  active  service  required  (three  months)  and  must  qualify  by  examination 
under  regulations  prescribed  by  the  Secretary  of  the  Navy. 

(h)  The  minimum  active  service  required  for  maintaining  the  efficiency 
of  a  member  (Naval  Coast  Defense  Reserve)  is  three  months  during  each 
term  of  enrollment.  This  active  service  may  be  in  one  period  or  in  periods 
of  not  less  than  three  weeks  each  year. 

(i)  A  member  receives  retainer  pay  of  $12  per  annum  while  enrolled  in  her 
provisional  grade,  provided  she  makes  such  reports  concerning  her  move- 
ments and  occupation  as  may  be  required  by  the  Secretary  of  the  Navy.  After 
confirmation  in  grade  her  annual  retainer  pay  is  two  months'  base  pay  of  nurse 
in  the  Navy.  Retainer  pay  is  in  addition  to  any  pay  to  which  a  member 
may  be  entitled  by  reason  of  active  service.  As  noted  below,  members  of 
the  Volunteer  Naval  Reserve  do  not  receive  any  retainer  pay. 

(i)  A  member  who  reenrolls  for  a  term  of  four  years,  within  four  months 
of  expiration  of  last  complete  enrollment,  and  who  has  performed  the  minimum 
amount  of  active  service  required  during  the  preceding  term  of  enrollment,  for 
each  reenroUment  receives  an  increase  of  25  per  cent  of  her  base  retainer 
pay.  A  member  who  completes  20  years  of  service,  and  who  has  performe;l 
the  minimum  amount  of  active  service  to  maintain  efficiency  during  each  term 
of  enrollment,  on  her  own  application  will  be  retired  with  grade  held  at  the 
time,  with  a  cash  gratuity  equal  to  the  total  amount  of  her  retainer  pay 
during  her  last  term  of  enrollment. 

(fc)  A  member  may  accept  employment  in  any  branch  of  the  public  service 
except  as  a  nurse  in  any  branch  of  the  military  service  of  the  United  States 
or  any  State  thereof.  In  other  words,  a  nurse  enrolled  in  the  Naval  Reserve 
Force  can  not  obligate  herself  to  other  military  authority. 

(?)  A  member  is  subject  to  the  laws,  regulations,  and  orders  for  the  govern- 
ment of  the  Regular  Navy  only  during  such  time  as  she  may,  by  law.  be  re- 
quired to  serve  in  the  Navy  in  accordance  with  her  obligation,  and  w^hen  on 
active  service  at  her  own  request,  and  when  employed  in  authorized  travel  to 
and  from  such  active  service  in  the  Navy. 

(m)  A  distinctive  badge  or  button  will  be  issued  to  be  worn  only  by  members 
of  the  United  States  Naval  Reserve  Force.  A  penalty  is  assigned  when  un- 
authorized persons  wear  or  use  this  emblem. 

(n)  A  member  when  actively  employed  is  entitled  to  the  same  pay  and 
allowances,  gratuities,  and  other  emoluments  as  a  nurse  in  the  Navy  Nurse 
Corps  of  corresponding  grade  and  of  the  same  length  of  service.  When  not 
actively  employed,  a  member  is  not  entitled  to  pay,  bounty,  gratuity,  or  pension, 
except  as  expressly  provided  by  the  provisions  of  the  act  of  August  29,  1916, 
creating  the  Naval  Reserve  Force. 

792.  (a)  Enrollment  of  persons  shall  be  made  in  the  Naval  Coast  Defense 
Reserve,  class  4,  or  Volunteer  Naval  Reserve  for  duty  in  the  Naval  Coast 
Defense  Reserve,  class  4,  United  States  Naval  Reserve  Force.  (Members  of 
the  Volunteer  Naval  Reserve  receive  no  retainer  pay  or  uniform  gi-atuity  in 
time  of  peace,  but  when  on  active  duty  they  receive  the  service  pay  of  their 
gi'ade  and  service.) 

(b)  A  candidate  for  enrollment  as  above  must  be  "between  22  and  44  years  of 
age  and  a  citizen  of  the  United  Slates,  and  unmarried.  She  must  be  a  gradu- 
ate of  a  reputable  training  school  connected  with  a  recognized  general  hospital, 
giving  not  less  than  two  years'  continuous  training.  Candidates  for  enrollment 
from  States  where  State  board  laws  are  operative  are  required  to  be  registered 


58  MANUAL   FOR    THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

(o)   Application   for  enrollment   must   be  made   in   the   handwriting   of  the 
applicant  according  to  the  following  form: 


(Residence.) 
,  19_-. 


Sre:  I  request  permission  to  be  examined  for  enrollment  in  the  provisional 
grade  of  nurse,  Naval  Coast  Defense  Reserve,  class  4,  United  States  Naval 
Reserve  Force.* 

I  was  born  at — — ,  and  was years  of  age  on  the 

day  of — ,  19 ;  graduated  from train- 
ing school ,   19 ,   and  am  a   registered   nurse   in   the   State 

of 

I  am  a  citizen  of  the  United  States,  residing  in ,  county 

of ,  in  the  State  of 

I  forward  herewith  letters  testifying  to  my  moral  character,  preliminary 
education,  nursing  education,  registration  certificate,  and  professional  qualifi- 
cations.* 

Very  respectfully, 


(Name  in  full  written  legibly.) 
Chief  of  the  Bureau  of  Medicine  and  Subgkky, 

Navy  Department,  Washington,  D.  C. 

(d)  The  above  application  must  be  accompanied  by  the  following  certificates: 

(1)  letters  or  certificates  from  two  or  more  persons  of  good  repute  testify- 
ing from  personal  knowledge  to  good  habits  and  moral  character. 

(2)  A  certificate  of  preliminary  education.  The  candidate  must  submit  a  cer- 
tificate of  graduation  from  an  accepted  high  school  or  a  certified  statement  of 
an  acceptable  equivalent. 

(3)  Certificate  of  nursing  education.  This  certificate  should  give  the  name 
of  the  school,  the  hospital  with  which  it  is  connected,  and  the  date  of  gradua- 
tion. 

(4)  Letter  from  the  alumna  association  of  which  she  is  a  member. 

(5)  Certificate  of  registration,  or  certified  copy  thereof. 

(6)  If  the  candidate  lias  had  hospital  service  or  special  educational  or  pro- 
fessional advantages,  certificates  to  this  effect,  signed  by  the  proper  authori- 
ties, should  also  be  forwarded. 

A  certificate  of  enrollment  in  the  American  Red  Cross  will  be  accepted  in 
lieu  of  the  above  certificates. 

(e)  The  applicant  will  save  unnecessary  correspondence  if  she  will  make  sure 
when  submitting  her  application  that  the  qualifications  enumerated  above  are 
clearly  and  plainly  described  in  her  letters  or  certificates. 

793.  After  passing  upon  the  credentials  of  a  candidate  the  Bureau  of  Medi- 
cine and  Surgery  will  direct  the  examination  of  the  candidate  for  enrollment 
in  the  provisional  grade  of  nurse  in  accordance  with  the  following  instruction : 

(a)  Pfofessioiial  examination. — (1)  Certificates  with  regard  to  the  profes- 
sional ability  of  the  candidate  will  be  obtained  by  the  Bureau  of  Medicine  and 
Surgery  from  superintendents  of  training  schools  and  from  State  boards  of 
examiner.';. 

(2)  Candidate.s  may  be  required  to  take  a  written  examination  in  the  fol- 
lowing subjects:  Anatomy,  physiology,  materia  inedica.  medical  and  surgical 
nui*sing,  and  dietetics.    Two  questions  in  each  subject. 


*When  directed,  the  applicant  should  substitute  the  words  "  Volunteer  Naval  Resrive 
for  duty  In  the  Naval  Coast  Defense  Heservc.  class  4.  I'nited  Rt.ites  Nav.nl  Rosorvo  Force." 
for  the  words  "  Naval  Coast  Defense  Rcservo.  class  4,  United  Rtad'S  Reserve  I-'orce." 

•These  certlflcates,  mentioned  in  detail  elsewhrri^,  are  not  required  of  applicants  who 
have  been  nurses  with  n  clear  record  of  service  In  ilie  Nurse  Corps  vi  the  Army  or  Navy  ; 
but  these  applicants  will  he  required  to  state  the  period  of  their  Army  or  Navy  service, 
and  also  to  submit  evidence  of  professional  employment  following  discharge  from  the 
service. 


MANUAL    FOR    THE    MEDICAL   DEPARTMEXT,    U.    S.    NAVY.  59 

(3)  When  the  written  ex:uniuatiou  (/>)  is  not  required,  the  candidate  will 
submit  a  prescribed  essay  on  nursing  subjects  designated  by  the  Bureau  of 
Medicine  and   Surgery. 

(4)  AVheu  the  written  examination  {b)  and  the  essay  (c)  are  not  required, 
the  Bureau  of  Medicine  and  Surgery  may  direct  an  oral  examination  to  be 
conducted  by  such  examiners  and  at  such  places  as  may  be  detei-mined  upon 
by  the  bureau. 

Due  credit  will  be  given  for  knowledge  and  experience  in  the  case  of  candi- 
dates who  have  specialized  in  certain  branches  and  who  have  had  exceptional 
institutional   experience,   and   the   examination   will   be   modified   accordingly. 

(ft)  Physical  ca;amination.—HeiK>Ytfi  of  physical  examination  must  be  made 
by  a  medical  examiner  on  blank  forms  supplied  by  the  bureau  for  this  purpose. 
The  reports  are  not  given  to  the  candidate,  but  are  sent  direct  to  the  Bureau 
of  Medicine  and  Surgery  and  are  regarded  as  confidential. 

No  allowance  will  be  made  for  the  expenses  of  persons  appearing  for  exam- 
ination. 

Candidates  may  appear  for  examination  before  a  medical  officer  of  the  Army 
or  Navy. 

794.  The  examination  papers  and  reports  are  forwarded  to  the  Bureau  of 
Medicine  and  Surgery,  Washington,  D.  C.  for  approval.  When  the  candidate 
is  found  mentally,  morally,  professionally,  and  physically  qualified,  the  Surgeon 
General,  United  States  Navy,  will  recommend  to  the  Bureau  of  Navigation  that 
the  candidate  be  provisionally  enrolled  as  a  nurse.  Naval  Coast  Defense  Reserve, 
class  4,  United  States  Naval  Reserve  Force. 

795.  Confirmation  in  graile. — Nurses  provisionally  enrolled  in  the  Naval 
Coast  Defense  Reserve,  class  4,  who  apply  to  the  Bureau  of  JNledicine  and 
Surgery  for  permission  to  perform  the  minimum  amount  of  active  service 
required  for  confirmation  in  grade,  and  who,  after  completing  the  active  service 
required,  request  permission  to  be  examined  for  confirmation  in  grade,  will 
be  given  an  examination  in  accordance  with  the  following  instructions: 

(rt)  Physical  examination. — A  report  of  physical  examination  on  the  pre- 
scribed form  submitted  by  the  bureau  will  be  required. 

(&)  Professional  examination. —  (1)  Letter  from  the  candidate  to  the  Sur- 
geon General  giving  a  brief  statement  of  her  professional  education. 

(2)  Examination  of  acitve-service  record  as  noted  in  the  filed  eiliciency 
reports. 

(3)  A  Avritten  or  oral  examination  will  be  required  to  determine  whether 
or  not  the  candidate  possesses  a  knowledge  of  Navy  Regulations  and  the 
Manual  for  the  Medical  Department  appropriate  to  her  grade.  This  examina- 
tion will  be  sufficiently  comprehensive  to  determine  the  candidate's  qualifica- 
tions to  perform  the  duties  of  a  nurse  under  the  usual  service  conditions. 

796.  Those  nurses  provisionally  enrolled  in  the  United  States  Naval  Coast 
Defense  Reserve,  class  4,  who  have  been  found  qualified  by  examinations  will 
be  confirmed  in  grade. 


CHAPTER  6. 


THE  DUTIES  OF  MEDICAL  OFFICERS    (AND  DENTAL  OFFICERS). 
Section  1. — Laws  Relating  to  Duties  Afloat. 

801.  Distilled  spirits  only  as  medical  stores  for  medical  purposes.  Sec.  1624, 
R.  S. ;  R  13. 

802.  Commanding  officer  to  consult  surgeon  regarding  health  of  crew. 
R  20  (8). 

803.  Duties  of  fleet  surgeon.    Sec.  1374,  R.  S. 

804.  Loss  of  pay  of  officers  and  men  for  absence  from  duty  on  account  of 
disease  resulting  from  intemperate  use  of  drugs  or  alcoholic  liquors,  or  other 
misconduct.    Act  April  27,  1914.    Act  August  29,  1916. 

Section   2. — Navy   Regulations   Relating   to   the   Duties   of   the   Medical 

Officer  of  a  Ship. 

811.  (a)   Organization  of  the  Medical  Department.    I  2501  (1). 

( ft )   General  duties  and  authority  of  medical  officer.     R.  2951. 

812.  Contagious  and  infectious  diseases,  prevention,  care,  and  treatment  of 
R  2952. 

813.  Sanitary  condition  of  ports  visited.     R  2953. 

814.  Sanitary  suggestions  and  reports.     I  1122  (5)  ;  R  2954. 

815.  Precautious  against  disease  among  personnel  of  the  ship.     R  2955   (1). 

816.  Malingering.     R  2955  (2). 

817.  Concealed  diseases.     R  2955  (3). 

818.  Relief  of  wounded  and  instruction  in  first-aid.     R  2956. 

819.  Killed  and  wounded,  report  of.     R  2957. 

820.  Inspection  of  food  for  the  ship.     R  2959. 

821.  Unofficial  certificates  of  ill  health  prohibited.     R  29.58. 

822.  Medical  survey  or  transfer  to  hospital  of  persons  unfit  for  duty.     R  2960. 

823.  Transfers: 

(a)  Medical  officer  to  accompany  serious  cases,  if  practicable.    R  2961  (1). 

(b)  Papers  accompanying  patients.    R  2961  (2). 

(c)  Examination  of  men  before  transfer.    R  2961  (3). 

824.  Patients  transferred  to  other  than  naval  hospitals,  procedure  regarding: 
(a)   Medical  history  continued  until  ship  leaves  port.    R  2962  (1). 

(&)   Health  record  transferred  to  consul  upon  departure.    R  2962  (2). 

(c)  Medical  officer  of  a  ship  arriving  in  port  to  take  charge  of  such  patients. 

R  2962  (3). 

(d)  Hospital  expenses.     R  2962  (4). 

(e)  Patient  so  transferred  or  received  shall  be  reported.    R  2962  (5). 

825.  Certificate    (report)   of  death: 

(a)  Prepared   in   duplicate  and  one  additional  for  commander  in  chief. 

R  2963   (1). 
(5)   In    case    of    officers,    additional    copy    to    Bureau    of   Navigation.      I 

5247  (36). 
(c)   Origin  of  disease  or  injury  causing  death  to  be  noted  with  reasons. 
(See  also  Fleet  Regulations.)     R  2963  (2). 

61 


62  MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

826.  Medical  storeroom,  precautious  regarding.    R  2964. 

827.  Custody  of  spirits,  wines,  and  malt  liquors.     R  2965. 

828.  Epidemic  or  contagious  diseases,  reports  of;  and  sanitary  data  from 
foreign  ports.    R  2953 ;  R  2966. 

829.  Duty  in  conuectiou  with  Indorsement  on  records  of  summary  courts- 
martial.     R  621 ;  R  2967. 

830.  Absence  or  disability  of  medical  officer,  next  in  rank  to  succeed.    R  2968. 

831.  Officer  detached  during  cruise  to  inspect  department  with  his  relief. 
R  2051. 

832.  Loss  of  pay  of  officers  and  men  for  absence  from  duty  on  account  of 
disease  resulting  from  intemperate  use  of  drugs  or  alcoholic  liquors  or  other 
misconduct.    General  Orders  Nos.  100  and  231. 

833.  To  prepare  misconduct  reports;  see  2820.  General  Orders,  Nos.  100 
and  231. 

Section  3. — Navax  Instbuctions  Relating  to  the  Duties  of  the  Medicai- 

Officer  of  Ship. 

841.  Duties  connected  with  the  fitting  out  of  a  ship.    I  2101. 

842.  Examination  of  crew  and  verification  of  records.    I  2102. 

843.  Vaccination.     12103;  13211;  13212. 

844.  Charge  of  sick  bay  and  other  compartments  under  Medical  Department 
to  be  assumed  by  the  medical  oflicer.    I  2104. 

846.  Attention  paid  the  .sick  by  Hospital  Corps  and  when  to  summon  medical 

officer.  I  2105   (1-2). 

846.  Consultation  with  other  officers  regarding  professional  treatment    1 2106. 

847.  Daily  report  of  sick.     I  2107, 

848.  Binnacle  list.     12108. 

849.  Instruction  in  first  aid.    1 2109 ;  1 2641. 

850.  Ini^ection  of  provisions  for  crew.     12110;  12618  (2). 
861.  Preparation  of  food.     12111. 

852.  Testing  water.    I  2112. 

853.  Inspectio  nof  fresh  provisions  and  contents  of  bumboats.  12113  (1-2)  ; 
I  1802  (1)  ;  I  4482  (1). 

854.  Inspection  of  cells  and  prisoners.     12114. 

865.  Inspection  of  living  spaces,  holds,  and  storerooms.    I  2115  ;  I  2702  (2). 

866.  Patients  received  for  passage.    I  2116. 

867.  Health  records.     I  2117  (1-2)  ;  R2994;  1707  (5). 

868.  Invoices  and  receipts  of  medical  stores  and  supplies.    I  2118  (1-7) 

869.  Requisitions  for  ensuing  six  months : 

(o)  Receiving  ships  and  ships  in  reserve.    I  2119  (l)c. 

(ft)  Cruising  ships.    I  2119  (2). 

(c)  Ships  on  detached  service.    I  2119  (4). 

(d)  Special  requisitions.    I  2119  (5). 

(e)  Medical  supplies  for  ships  at  navy  yards.    I  4475. 

860.  Allowances  of  medical  stores  and  supplies, 
(a)  Based  on  supply  table.    I  2120  (1). 

(6)   Purchase  to  be  avoided  if  possible.    I  2120  (2). 

(c)  Stores  for  sick  from  other  departments.    I  2120  (3). 

(d)  Transfer  of  supplies  between  departments.    I  4422. 

(e)  Supplies  or  services  in  emergencies.    I  4472  (6). 
(/)  Medical  supplies  for  ships  at  navy  yards.    I  4475. 

(g)  Medical  supplies  purchased  to  be  selected  by  the  head  of  department 
I  4480. 

861.  Laundry  and  extra  provisions.     12121. 

862.  Surgical  instruments  and  ajipliances  replaceable  only  after  survey. 
I  2122. 

868!  Loss  of  medical  stores,  etc.     I  2123. 


MANUAL  FOE   THE   MEDICAL  DEPARTMENT,,  U.    S.    NAVY.  63 

864.    (1)   Medical  outfit  when  going  out  of  commission.     12124  (1), 

(a)   Medicai  supplies,  etc.    I  2124  (l)a. 

(6)   Mirroscopical  outfit,  etc,     (I  2124  (l)b. 

(c)   Journal.    I  2124  (l)c. 

(2)   Sliips  in  reserve.    I  2124  (2). 
805.  Transfer  of  stores. 

(a)   One  medical  officer  to  another.    I  2125  (1). 

(6)   Medical  officer  to  his  successor.    I  2125  (2). 

(c)  Hospital  corpsman  to  his  successor.    I  2125  (3). 

866.  Bills  of  health.     I  2126. 

867.  Sanitary  report.  I  2127.  Also  monthly  from  vessels  of  a  fleet  to  com- 
mander in  chief  giving  summary  of  contagious  diseases  and  sanitary  suggestions 
as  required. 

868.  Duty  in  battle.     12128. 

869.  (a)   Station  and  duty  at  quarters.     12129  (1). 

(b)  Surgeon's  division.     I  2129  (2). 

(c)  Duties  of  medical  officer  as  divisional  officer.    I  2129  (3)  ;  I  2501  (l)c. 

870.  Personnel  of  surgeon's  division. 

(a)  Composition  and  additional  attendants.    I  2130  (1). 

( b )  Under  medical  officer  for  issue  of  money,  small  stores,  and  clothing.    I 
2130  (2).  :'• 

871.  Breaches  of  discipline.     12131,  "' 

872.  Binnacle  list  and  morning  report  of  sick  should  correspond. 

The  primary  object  of  the  binnacle  list  is  to  supply  the  officer  of  the  deck  and 
other  persons  concerned  with  readily  obtainable  information  regarding  men 
excused  from  duty.  The  names  of  men  excused  after  the  morning  report  to 
the  commanding  officer  has  gone  in  are  added  to  the  binnacle  list,  and  If  still 
unfit  for  duty  on  the  following  day  should  then  be  regularly  admitted  to  the 
sick  list  and  entered  on  morning  report  to  the  commanding  officer  for  his 
information,  if  necessary,  under  the  caption  "  for  observation,"  etc.  Failure 
so  to  do  vitiates  statistics,  leads  to  omissions  from  the  health  record  of  data 
that  may  be  of  great  importance  later  on,  and  misrepresents  the  facts.  For 
example,  a  ship  having  a  complement  of  100  men  with  3  men  on  the  sick  list 
reports  3  per  cent  sick ;  a  ship  with  10  men  on  the  binnacle  list  only  would 
report  0  per  cent  sick,  with  obvious  injustice  to  the  former  vessel's  relative 
standing. 

Section  4. — Navy  Regulations  and  Naval  Instructions  Applying  to  Juniob 

Medical  Officees. 

881.  General  duty.     R  2976. 

882.  To  keep  health  records.     R2977, 

883.  To  consult  with  the  medical  officer.    R  2978. 

884.  Permission  to  leave  ship.    R  2979. 

Section  5. — Miscellaneous  Duties  of  the  Medical  Offices  Afloat. 

891.  Board  of  inspection  and  survey  for  ships.    R  157  (1). 

Note. — The  medical  officer  of  the  board  will  carefully  inspect  the  Medical  De- 
partment of  the  ship  in  all  details.  He  will  also  carefully  examine  the  entire 
ship  in  regard  to  its  sanitary  condition,  hygienic  regulations,  and  its  efficiency 
from  a  professional  point  of  view,  noting  particularly  its  ability  to  cope  with 
a  contagious  disease  or  the  adequacy  of  the  arrangements  for  action,  (Extract 
from  "  Report  of  Board  of  Inspection.") 

892.  Boards  of  inquest.     R  321  (2)  R  322  (3). 

893.  Boards  of  medical  examination.     R  3551  (7-8)  R3525. 

894.  Boards  of  medical  survey.    R  361-866. 

895.  Medical  certificate  on  court-martial  proceedings.     R  2967;  R  621  (1). 

896.  Attention  to  comfort  and  welfare  of  troops  embarked,    R3847  (2), 


64  MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.    S.    NAVY. 

897.  Meilical  certificate  on  niembors  of  general  court-martial.    R  727  (4). 

808.  Report  on  prisons,  brigs,  and  other  continement  spaces.    R  1431  (1). 

89J).  Medical  aid  to  persons  not  in  the  Navy.    R  1607. 

900.  Duty  of  boards  to  examine  ships  empk)ye<l  to  transport  sick.    I  953. 

901.  Report  indicating  use  of  intoxicants  or  drugs.    1707(5). 

902.  Report  on  use  of  harbor  water  on  deck.     I  2621. 

903.  Care  of  inllannnable  medical  stores,  acids,  etc.    12707  (5). 
'904r.  Selection  of  medical  supplies.    I  44S0. 

905.  Certificate  of  admission  to  or  discharge  from  hospital  (foreign). 
I  4Si)0  (6). 

906.  Medical  attendance  of  personnel  of  vess'els  in  reserve.    1570  (3). 

907.  Board  of  survey  on  material.     I  4749  (1-6). 

908.  Examination  of  officers  for  periodical  pliysical  exercise.    1709. 

909.  Instruction  in  first-aid  to  officers.     I  2G41, 

910.  Instruction  of  the  hospital  corps.     I  2642. 

Section  6. — Navy  Regulations  Applying  to  Duties  of  Medical  Officers 

Ashore.' 

911.  Duties  of  medical  officers  at  shore  stations.     (R3941  (l)h)  R  2901  (2). 

912.  General  duties  at  navy  yards  and  naval  stations.     114006  (1-3). 

913.  Attendance  on  officers'  families  in  Washington.    R  4006  (4). 

914.  Rules  governing  attendance  on  officers'  families.    R  4006  (5-6). 

915.  Expenditure  of  medical  stores.    R  4006  (7). 

916.  Precautions  regarding  contagious  and  infectious  diseases.    R4006  (8). 

917.  Injured  employees  at  navy  yards.     (13411)  R  4006  (9). 

918.  Medical  supplies  at  navy  yards.     R  4623. 

919.  Junior  medical  officers  at  shore  stations.    R4007. 

921.  Duties  of  medical  officers  of  navy  yard  in  connection  with  yard  service 
and  employees'  compensation  for  injuries.     (See  ch.  12,  sees.  8-11.) 

922.  Duties  of  medical  officers  at  recruiting  stations.     (See  ch.  12,  sees.  4-6.) 

923.  Duties  at  naval  hospitals.     (See  ch.  8.) 

924.  liOss  of  pay  of  officers  and  men  for  absence  from  duty  on  account  of 
disease  resulting  from  intemperate  use  of  drugs  or  alcoholic  liquors,  or  other 
misconduct.     General  Orders,  Nos.  1(X)  and  231. 

Section  7. — Naval  Instructions  Relating  to  Duties  of  Medical  Officebs 
Ashore.     (See  also  ch.  12.     Employers'  Liability  Act.) 

931.  Duties  under  employees'  compensation  act.    I  391-393. 

932.  Duties  as  head  of  department  at  navy  yard.    I  3433. 

933.  Duties  as  medical  officer  of  yard: 
(c)   Daily  report  of  sick.     I  3461   (1). 

(b)  Examination  of  recruits.     I  3461  (2). 

(c)  Applicants  for  pensions.     I  3461    (3). 

934.  Inspection  of  medicnl  supplies.     I  46Y8. 

935.  Selection  of  medical  supplies,  etc.,  for  jiurcliase.    I  44,S0. 

936.  Medical  officer  of  shore  station  to  keep  a  hU]  hook.    I  .■>2r>S. 

937.  Duties  of  medical  otBcers  at  naval  prisons  and  prison  ships.  (See  Rules 
and  Regulations  for  the  Government  of  Naval  Prisons,  etc.,  arts.  9,  25,  55-60, 
and  99.) 

93S.  Senior  medicnl  officer  at  Nav;il  Academy  to  he  head  of  department  of 
uaval  hygiene  and  physiology  and  act  as  member  of  the  academic  board. 
fOen.  Onier  No.  10,  Feb.  15,  1909.) 

939.  The  expenditure  of  medical  stores  authorized  by  R  4006  (7)  will  he 
limited  to  such  stores  as  are  required  to  Carry  out  the  treatment  prescribed 

1  For  (Intios  at   nnvMl   hospitals  spp  rh     8.  Rf^rs.    (.%)    (rt)    (7)    (H)    (0). 


MANUAL  FOE   THE    MEDICAL  DEPARTMENT,  TJ.    S.    NAVY.  65 

by  the  medical  officer  and  will  under  no  circumstalnces  be  construed  to  include 
expenditures  for  any  other  purposes. 

Section    8.^ — Medical    Instructions.     Physical    Examination    of    Recruits. 

(See  also  ch,  11.) 

941.  Records  of  examination.     I  3201. 

942.  Only  medical  officers  to  conduct  examinations.     I  3202. 
913.  Examination  must  be  completed  In  every  case.    I  8203. 

944.  Care  to  he  exercised  in  examinations.     I  3204. 

945.  Examination  of  the  applicant.     I  3205. 

946.  Intelligence  to  be  estimated  from  replies  to  questions.    I  3206. 

947.  Age  to  he  considered  in  determining  standards.    I  3207. 

948.  Entries  to  be  made  on  service  and  health  records.    I  320S  (1-2). 

949.  Procedure  when  defects  are  waived  by  Navy  Department.    I  3209. 

950.  Reexamination  of  recruits  sent  from  a  rendezvous.    1  3210. 

951.  Recruits  to  be  vaccinated.     I  3211  (1-2). 

952.  Typhoid  prophylaxis  to  be  administered  to  all  persons.    I  3212. 

Section    9. — General    Instructions    Relating    to    the    Duties    of    Medical 

Officers. 

961.  Medical  officer  to  keep  a  journal.    I  3251. 

962.  Health  records  and  all  other  records,  how  to  be  kept.    I  3252. 

963.  Prescription  book.    I  3253. 

964.  Statistical  report  of  sick.     I  3254. 

965.  Accountability  for  property  expended.    I  3255  (1-4). 

967.  Health  record  oi)ened  for  all  persons.    I  3257. 

968.  Bill  book.    I  3258. 

969.  Sanitary  report  from  shore  stations.     I  3259. 

970.  Employees  not  to  have  financial  dealings  with  patients.    I  3260. 

971.  Hospital  and  ambulance  service.     I  3261. 

973.  Biennial  examination  of  pensioners.     R.  S.  4771. 

974.  Eyesight  examination  of  candidates  for  gun  pointer.    I  2501  (3). 

Section  10. — Miscellaneous  Duties  Afloat. 

981.  (a)  He  shall  see  that  the  personnel  of  the  Medical  Department  is  at  all 
times  prepared  for  emergencies,  especially  during  drills,  coaling  ship,  and 
other  evolutions.  Due  prominence  should  be  given  to  the  importance  of 
their  being  immediately  available  for  aseptic  work. 

(&)  He  shall  carry  out  all  the  duties  required  of  a  divisional  officer  under 
Art.  I  1822  to  I  1827,  inclusive. 

982.  Collision  drill:  The  surgeon's  division  will  make  necessary  preliminary 
preparation  for  saving  the  sick. 

983.  Fire  drill :  The  surgeon's  division  will  make  preliminary  provision  for 
the  removal  of  the  sick.  Inflammable  liquids  under  the  surgeon's  charge  will  be 
removed  to  a  place  of  safety,  or,  if  necessary,  thrown  overboard.     I  2707  (5). 

984.  Fire  and  rescue  party:  A  medical  officer  is  detailed  for  duty  with  the 
fire  and  rescue  party.  He  will  provide  the  necessary  medical  outfit  and  will  ac- 
company the  party  whenever  it  is  called  away,  if  the  Fleet  Regulations  so 
require. 

985.  Clear  ship  for  action:  The  surgeon  will  prepare  for  action  in  accord- 
ance with  instructions  under  "  Medical  Department  in  battle,"  chapter  10.  He 
will  inspect  the  dressing  stations:  see  that  the  men  detailed  therefor  are 
present ;  that  they  understand  the  duties  required  of  them ;  that  they  are  ready 
for  duty,  and  that  these  stations  are  properly  equipped.  He  will  see  that  the 
means  for  transporting  the  wounded  are  provided,  and  that  all  arrangements 

98601°— 17 5 


6G  MANUAL  FOE    THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

lu'cessar    for  the  (.-are  of  the  wounded  are  made  at  this  exercise.     (See  also  Pt. 
in.  Ship  .md  Gun  Drills.  1905.) 

987.  Tlie  hospital  boat  will  carry  no  arras  whatever  and  will  fly  a  Red 
Cross  flag  on  a  .staff  in  the  bow.     (Boat  Book,  1908,  art.  21.)  •        .  '-? 

Section  11. — Outline  of  Instuuction  in  First  Aid, 

j^T^TE. — In  connection  with  all  first-aid  instruction  to  officers  and  enlisted  men 
of  the  ambuhuue  party  the  medical  officer  shaU  bear  in  mind  the  necessity  of 
treatins  those  sulijects'  in  simple  terms.  (I  2641.)  (See  Handy  book  for  the 
Hospital  Corps,  U.  S.  Navy,  1917.) 

1001.  The  following  outline  of  instruction  is  designed  to  insure  uniformity. 
First-aitl  in  the  Navy  comprehends  the  assistance  furnished  the  wounded,  ex- 
hausted, or  disabled  individual  by  anyone  near-by  until  lie  can  be  reached  by 
stretcliermen,  hospital  corpsmen  or  a  medical  officer.  It  is  as  important  t<> 
know  what  may  not  be  accomplished  by  lirst-aid  as  what  may  be  accomplished. 
Hemorrhage  from  large  arteries  of  the  thigh,  for  example,  may  be  controlled 
by  lirst-aid  procedures,  but  this  is  not  possible  in  hemorrhage  from  the  large 
arteries  of  the  abdomen. 

first  period. 

1002.  Contents  of  the  first-aid  packet  and  the  shell-wound  dressing.  (Ex- 
hibit the  first-aid  package,  and  during  the  course  of  instruction  open  it  and 
exhil)it  its  contents.)  Tlie  compress  is  made  of  cotton  gauze  which  has  been 
boiled  in  water,  or  steamed,  that  is,  sterilized  long  enough  to  destroy  any 
germs  which  may  have  been  present.  It  is  then  dried  at  a  very  high  tempera- 
ture. In  the  firs't-ald  packet  the  gauze  is  packed  under  heavy  pressure,  so  as  ti> 
take  up  as  small  a  space  as  possil)le.  This  packet  is  designed  to  cover  the 
wounds  made  by  bullets  from  small  arms. 

1003.  The  shell-vvound  dressing  is  made  from  the  same  material,  but  is  ot 
large  size,  because  a  shell  wound  from  shell  fragments  or  shrapnel  is  usmiUy  a 
large  wound.     (Exhibit  shell-wound  dressing  and  explain  its  construction  .apd 

application.)  •  ^  -,r>\  "  ' 

The  .shell-wound,  or  large-wound,  dressing  consists  of  a  gauze  pad  lb  layers 
thick  and  8*  to  9  by  10  inches,  held  in  place  by  a  four-tailed  bandage,  and  is 
made  as  follows:  From  the  standard  gauze  roll  of  four  thicknesses  and  8^  to  9 
inches  wide,  cut  off  a  length  of  40  inches.  Fold  the  free  ends  over  so  that  they 
meet  in  tlie  middle.  Now  fold  a  .second  time  along  the  line  wliere  the  free  ends 
meet.  The  length  lias  thus  l)een  reducwl  to  10  inches  and  the  thickness  in- 
crefised  to  10.  Tear  oft"  a  piece  of  unbleached  muslin  9^  by  00  inches.  Lay 
the  gauze  compress  in  the  center  of  tiie  muslin  and  fasten  it  there  l)y  sewing 
along  the  sides  toward  the  binders  and  diagonally  from  corner  to  corner.  Eadi 
free  end  of  the  unbleached  muslin  is  now  torn  down  the  middle  to  the  jiad  so 
as  to  give  a  four-tailed  bandage.  Fold  the  dressing  along  tla>  center  by  its 
sliort  dimension  so  that  the  gauze  is  on  the  inside,  the  muslin  binders  on  the 
oulslde.  Now  fold  the  upper  tails  on  themselves  in  layers  the  width  of  the 
exi«used  half  of  the  muslin  back.  Do  the  same  for  the  lower  iniir.  (.)nce  more 
iJUe  dressing  is  folded,  but  now  at  right  angles  to  previous  folds  so  as  to  bring 
the  tails  or  binders  in  apposition  to  each  other  and  inside  the  whole.  Cover 
with  a  piece  of  unbleached  muslin.  12  by  12  inches,  wrapping  like  an  ordinary 
Iiarcel  and  securing  with  a  couple  of  stitches.  Mark  plainly  with  indelible 
pencil,  slencil,  or  rublter  staini).  Sterilize  and  dry.  Wrapin  oiled  muslin  or 
jiaixr.  Six  to  11  dozen  of  th(;se  dressings  may  h^  wra]iped  together  in  caiivas 
and  kept  «t  each  gun  station  in  a  metal  box  secu!-ed  by  padlock  and  key.  The 
container  should  be  fasteniHl  to  a  bulkhead  adjacent  to  but  out  of  the  way  of  the. 
gun's  crew. 

It  will  be  advisable  to  have  at  dressing  .sUititms  a  (certain  nunilwr  of  shell- 
wound  dressings  of  larger  dimensions  than  those  given.     Xhese_\yill,UuL  be  tlis- 

O — j — II —    i(ii>i5»i 


MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY.  67, 

tributed  to  guns'  crows.  The  dimensions  recommended  are  10  hy  13  inclies  and 
each  pad  should  be  of  32  thiclcnesses  of  trauze.  (Explain  the  possibility  of 
avulsion  of  a  limb  or  wide  tearing  of  abdominal  wall  necessitating  a  large 
dressing  as  temporary  cover  and  why  the  dressings  are  aseptic  and  not  anti- 
septic in  view  of  various  uses  to  which  they  may  be  put.  Cf.  exposed  intestines, 
brain,  etc.) 

The  number  of  the  ordinary  shell-wound  dressings  prepared  in  advance  of  an 
engagement  should  be  in  the  ratio  of  40  to  each  100  of  the  crew ;  of  the  extra 
large  size  in  the  ratio  of  5  to  every  100  men.  While  there  might  be  no  call  , 
for  so  many  shell-wound  dressings  during  an  engagement  due  allowance  nnist 
be  made  for  deterioration  and  loss  after  preparation  and  before  battle  and  for 
the  possibility  of  wreckage  of  some  portion  of  supplies  during  action.  Some 
cases  may  need  reapplication  of  dressings  after  the  engagement. 

Undershirts  with  long  sleeves,  gloves,  and  a  handkerchief  tied  around  the 
neck  will  contribute  materially  to  lessen  the  danger  of  surface  burns  from 
explosives. 

100-t.  In  applying  one  of  these  dressings,  after  opening  the  first-aid  packet, 
or  the  covering  of  the  shell-wound  packet,  remove  the  compresses  contained  in 
paraffin  paper.  Unfold  each  compress,  being  careful  that  the  surface  to  be 
applied  to  the  wound  does  not  come  in  contact  with  anything  else,  and  above 
all  is  not  touched  b^'  the  fingers. 

1005.  Hemorrhage  (bleeding)  may  be  from  arteries  or  veins.  Wounds  that 
bleed  extensively  usually  indicate  bleeding  from  the  arteries ;  the  blood  spurts 
in  jets  or  flows  very  freely.  As  the  blood  is  pumped  from  the  heart  to  the  dif- 
ferent parts  of  the  body  and  is  coming  from  that  direction,  the  means  used  to 
stop  the  bleeding  must  be  applied  to  the  side  nearer  to  the  heart.  When  bleed- 
ing is  very  free  raise  the  limb  and  make  pressure  over  the  main  artery  with  the 
thumb  or  fingers  until  a  tourniquet  can  be  applied. 

1006.  A  tourniquet  is  the  best  means  of  stopping  severe  hemorrhage,  but 
should  be  used  only  when  arteries  are  severed.  The  rubber  tourniquet  is  the 
best.  To  apply  it,  grasp  a  section  of  the  tube  (large  enough  to  go  round  the 
bleeding  part)  and  stretch  it.  While  stretched,  apply  it  to  the  part,  well  above 
the  bleeding  point,  and  wind  it  oyer  and  over  until  only  enough  is  left  to  secure 
it.  Do  not  secure  it  with  a  square  knot;  two  round  turns  will  hold  the  tourni- 
quet in  place,  and  when  it  becomes  necessary  to  remove  the  tourniquet,  this  is 
easily  done.  A  tourniquet  may  be  made  of  any  strip  of  cloth  (as  a  handker- 
chief") tied  loosely  around  the  part  and  leaving  enough  space  to  insert  a  stick 
or  bayonet.  Wind  it  until  the  bleeding  stops,  then  secure  the  stick  wuth  a  piece 
of  bandage  or  cloth. 

1007.  A  tourniquet  should  not  be  left  on  a  limb  more  than  two  hours,  unless 
the  lower  part  of  the  limb  has  been  torn  away.  To  allow  a  tourniquet  to 
remain  on  the  part  too  long  will  cause  gangrene  or  mortification,  for  the 
reason  that  it  prevents  the  part  from  being  supplied  with  blood.  Do  not  use 
a  tourniquet  for  slight  bleeding.  This  mistake  is  frequently  made.  A'enous 
hemorrhage  is  sometimes  profuse  and  alarming,  but  local  pressure  and  eleva- 
tion will  control  it,  while  the  tourniquet  will  often  have  the  opposite  effect 
from  that  desired.  The  gauze  compress,  if  applied  very  firmly,  will  often 
stop  oozing  of  blood  from  wounds  not  involving  arteries,  and  it  is  iior 
as  likely  to  cause  gangrene.  (Demonstrate  the  application  of  the  tourniquet 
by  applying  it  to  the  arm  of  one  of  the  class.  Require  that  this  be  practiced 
by  each  member  of  the  class ;  have  the  pulse  felt  by  the  index  finger  to  demon- 
strate that  the  bleeding  would  be  effectively  stopped.  Demonstrate  the  appli- 
cation of  the  tourniquet  to  the  upper  part  of  the  thigh,  the  middle  of  the  leg. 
and  the  upper  arm,  explaining  tlie  anatomy  of  arterial  supply  to  the  regions. 
Require  that  this  be  practiced  by  each  member  of  the  class  under  instruction, 
having  him  first  apply  digital  pressure,  then  a  tourniquet.  Explain  how 
wounds  of  the  face  and  scalp  and  trunk  may  be  controlled  and  dressed.  Impro- 
vise a  tourniquet  from  a  strip  of  clothing  and  a  bayonet ;  demonstrate  its  use 
on  the  arm,  having  the  pulse  felt  to  indicate  its  efficacy.) 


68  MANUAL   FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 


SECOND    PEinOD.  ' 

1008.  Broken  bones.  Bones  are  often  broken  or  shattered  by  bullets  or  shell 
fragments.  After  bleeding  lias  been  stopped  and  the  dressing  applied,  the 
broken  bones  should  be  pulled  gently  until  they  are  in  proper  position  and  then 
placed  in  some  form  of  splint.  Pieces  of  board  (if  handy),  a  nlle.  boat 
stretcher,  pillow,  or  any  similar  object  may  be  useil.  Apply  splints  improvise  1 
from  boards  to  the  leg,  securing  the  same  by  strands  of  rope  or  pieces  of 

■clothing.  Importance  of  securing  splints  in  place  by  bandages  placed  well 
away  from  site  of  fracture.  Demonstrate  extension  and  counterextension  as 
used  for  the  reduction  of  fractures.  Require  the  class  to  practice  these  maneu- 
vers.    Display  diagrams  and  illustrations,  if  possible,  and  practice  the  same 

methods  as  are  illustrated.  i  -  <  *• 

■  I  'I' •' 

THIRD    PERIOD. 

1009.  "Wounds  in  general :  A  bullet  or  shell  fragment  may  produce  a  wound 
of  entrance  and  also  a  wound  of  exit,  if  it  pass  out,  and  both  wounds  should 
be  dressed.    Apply  a  compress  to  each  wound. 

1010.  Special  wounds:  Illustrate  the  application  of  the  compress  in  the  first- 
aid  package  to  a  wound  of  the  forearm.  Apply  it  (a)  simply  for  the  purpose 
of  dressing  the  wound;  (h)  securely  for  the  purpose  of  controlling  superficial 
hemorrhage.  Require  that  these  procedures  be  practiced  by  all  the  members  of 
the  class.  Demonstrate  the  application  of  the  compress  to  wounds  of  the  scalp, 
neck,  chest,  abdomen,  Imttock,  arm,  and  forearm,  thigh  and  leg,  and  the  foot, 
as  the  instruction  progresses.  Require  that  these  procedures  be  practiced  by 
all  the  members  of  the  class. 

Scalp  wounds:  Apply  the  compress  very  firmly  to  the  wound.  Hemorrhage 
is  arrested  by  tourniquet  or  bandage  carried  horizontally  around  head  just 
above  evebrows  and  ears  and  well  below  the  occiput. 

Neck':  The  back  of  the  neck  should  be  dressed  with  a  compress  and  the 
binder  rolled  around  the  neck.  Do  not  bind  too  firmly,  as  it  would  interfere 
with  breathing.  AVhen  the  great  vessels  in  the  neck  are  injured,  the  bleeding 
is  excessive.  Stuff  the  compress  into  the  wound,  using  two  or  three  if  they 
are  obtainable  or  combine  use  of  compress  with  digital  pressure.  Bind  firmly, 
but  be  careful  that  there  is  no  interference  with  the  breathing. 

Chest :  Bullets  or  shell  fragments  may  remain  in  the  chest  cavity  or  may  pass 
through  it.     Look  for  both  wounds. 

Abdomen:  Do  not  give  such  wounded  man  anything  to  drink;  the  fluid  may 
wash  the  contents  of  the  intestine  into  the  abdominal  cavity.  Place  the  wounded 
man  on  his  back  and  keep  him  as  quiet  as  possible.  Apply  a  compress  to  each 
skin  wound.  If  the  intestines  protrude,  replace  with  a  compress  and  .secure 
with  shell-wound  dressing. 

Buttock:  Unless  very  deep,  a  compress  will  answer  every  purpose.  In  the 
case  of  a  very  deep  wound  a  tourniquet  would  not  stop  the  bleeding. 

FOUKTH    PERIOD. 

1011.  Arm  and  forearm,  thigh  and  leg:  Apply  a  tourniquet  If  a  spurting 
vessel  is  noticed  or  if  the  bleeding  is  very  free.  If  not,  apply  the  compress 
firmlv  to  stop  the  bleeding. 

Palm:  Apply  one  compress  to  the  wound  directly  and  roll  a  second  into  a 
ball  ;  then  bind  firmly. 

P'oot :  The  sole  should  be  treated  the  same  as  the  palm  of  the  hand,  with  n 
very  firm  compress.  A  single  compress  firmly  applied  will  stop  the  bleeding 
from  wounds  of  other  parts  of  the  foot  or  ankle,  unless  the  main  vessel  is  sev- 
ered, in  which  ca.se  the  tourui(iuet  must  be  applied. 


MANUAL  FOR   THE   MEDICAL   DEPARTTMENT,  V.    S.    NAVY.  69 

FIFTH    PERIOD. 

1012.  Restoration  of  the  apjiarently  drowned :  Demonstrate  the  various 
movements  used  in  the  resuscitation  of  the  apparently  drowned.  Require  that 
this  be  practiced  by  each  member  of  tlie  class.  After  removing  the  shirts,  lay 
the  man  face  downward ;  stand  over  him  so  that  he  is  between  your  legs ;  clasp 
your  hands  under  the  lower  part  of  his  abdomen  and  raise  him  so  as  to  bring 
"the  water  from  his  lungs.  Then  place  liim  on  his  belly,  with  his  face  turned  to 
one  side.  Kneel  beside  him  and  place  the  palms  on  the  small  of  his  back  just 
below  the  ribs.  Lean  forward  and  gradually  bring  the  weight  of  the  body  on 
the  hands,  thus  forcing  air  out  of  the  lungs.  Avoid  roughness.  Release  pres- 
sure quickly  and  return  to  original  position. 

The  first  motion  should  occupy  about  two  or  three  seconds.  Aftei'  returning 
to  the  original  position  there  should  be  a  wait  of  about  two  seconds  before  re- 
peating; thus  there  will  be  aI)out  12  respirations  each  minute.  Imitation  of 
natural  breathing  is  the  object. 

These  efforts  should  be  kept  up  for  at  least  two  hours  or  until  natural  breath- 
ing is  restored.  (The  same  method  should  be  employed  in  resuscitation  for  elec- 
tric shock.     See  "  Handy  Book  for  the  Hospital  Corps,  1917.") 

If  you  succeed  in  starting  the  breathing,  continue  helping  him  until  he  is 
breathing  regularly.  All  wet  clothing  should  be  removed  while  attempting  to 
restore  him,  and  his  body  and  limbs  should  be  rubbed  upward  (in  the  direction 
of  the  heart).  The  man' should  be  wrapped  in  blankets  and  warmth  applied  in 
any  shape,  as  warm  bottles,  warm  bricks,  warm  sand,  or  even  a  hot  board  that 
may  have  been  in  the  sun.  Do  not  give  stimulants  before  the  man  can  swallow. 
Do  not  remove  him  until  he  is  conscious  and  breathing  naturally.  Watch  for 
several  hours  to  see  that  he  does  not  cease  breathing. 

Section  12. — Navy  Regulations  Relating  to  the  Duties  of  Dental  Officers. 

1021.  All  schools  for  the  education  of  officers  of  the  Dental  Corps  to  be  under 
the  supervision  and  control  of  the  Bureau  of  Medicine  and  Surgery.    R  2901  (3) 

1022.  The  authority  of  the  commanding  officer  of  a  hospital  ship  in  all  mat- 
ters concerning  the  discipline  and  punishment  of  dental  officers.    R  2919  (1). 

1023.  The  duties  of  dental  officers  assigned  to  the  Medical  Department  of  a 
ship  or  station.     R  2991. 

1024.  Care  and  attention  to  patients.     R  2992. 

1025.  To  keep  medical  officer  informed  of  condition  of  patients.     R  2993. 

1026.  To  keep  a  record  of  all  treatments  and  v/ork  performed.     R  2994. 

1027.  Care,  preservation,  and  accountability  for  property  in  their  charge. 
R  2995. 

102S.  Requisitions  for  and  return  of  dental  property.    R  2996. 
1029.  The   duties  of   acting   assistant   dental   surgeons   appointed   for   tem- 
porary service.     R  2997. 

Section  13. — The  Duties  of  Dental  Officers. 

1031.  Dental  officers  are  by  law  a  part  of  the  Medical  Department  of  the 
United  States  Navy,  and  are  required  to  serve  professionally  the  personnel  of 
the  naval  service  and  to  perform  such  other  duties  as  may  be  prescribed  by 
competent  authority. 

1032.  The  regulations  provide  that  the  professional  services  of  dental  officers 
shall  be  available  only  for  officers  and  men  on  the  active  list  of  the  Navy  and 
Marine  Corps,  and  such  services  are  restricted  to  those  measures  which  will 
most  effectively  and  economically  preserve  the  teeth  of  the  personnel  and 
insure  physical  fitness.  The  department  has  construed  Article  R  2991  to 
apply  to  and  include  officers  and  men  of  the  Naval  Auxiliary  Service.  (Dept. 
15G9-355.  Nov.  8,  1914;  M.  and  S.  126472.) 


70  .-^AXUAL    FOR    THE   MEDICAL   DEPARTMENT,   U.    S.    XAVY. 

1033.  Prosthetic  procedures,  such  as  gold,  bridge,  or  crown  w(n-k,  are  not 
contemplated  as  a  part  of  the  work  of  a  dental  officer. 

1034.  Dental  ofticers  will  keep  the  medical  officer  fully  informed  of  the  con- 
dition of  all  patients,  and  promptly  notify  him  of  any  case  which  may  require 
nie<lical  attention.  Should  it  appear  necessary  to  admit  a  patient  to  the  sick 
list,  the  dental  officer  will  report  the  circumstances  to  the  medical  officer  con- 
cerned, who  will  enter  the  case  on  his  record  in  the  customary  manner. 

1035.  The  record  of  all  dental  treatments  will  be  kept  on  the  slieet  provided 
for  that  purpose.  This  sheet  should  be  delivered  to  the  medical  officer  having 
charire  of  the  health  record  for  insertion  therein  immediately  following  the 
slH^t  for  the  medical  record.  The  dental  record  will  contain  a  record  of  the 
condition  of  the  patient's  teeth  when  first  examined  by  the  dental  officer,  and 
}\  record  of  all  subsequent  dental  operations  and  trea.tments. 

1030.  When  a  patient  is  sent  from  a  ship  or  station  to  another  ship  or 
station  for  dental  treatment,  the  dental  record  will  be  detached  and  sent  to  the 
dental  oflicer  concerned  or  else  a  statement  will  be  sent  that  no  dental  record 
exists.  The  dental  record  is  accompanied  by  a  statement  as  to  wliether  or  iiot 
patient  has  veneral  disease.  These  paper.s  go  in  a  sealed  envelope.  Upon 
completion  of  tivatment,  the  dental  officer  will  make  the  necessary  entries  over 
his  own  signatnie  and  leturn  the  dental  record  to  the  medical  officer  having 
charge  of  the  health  record.  Except  in  an  eniergency  the  medical  officer  should 
make  an  appointment  in  advance  when  he  has  to  send  patients  to  the  dental 
<;flUer  of  another  ship.     (See  also  Fleet  Regulations.) 

1037.  The  statistical  report  of  dental  work  done  on  a  ship  or  station  will  be 
included  in  the  statistical  report  of  the  Medical  Department  of  that  ship  or 
station. 

Returns  of  dental  property,  requisitions,  and  reports  will  be  forwarded 
through  the  senior  medical  officer.      (Pars.  2270.   23SS.) 

1038.  A  hospital  corpsman  may  be  assigned  for  duty  with  the  dentist. 

1039.  Dental  officers  will  requisition  for  supplies  as  prescribed  in  paragraph 
."iOBl -2,  Manual.  Jledical  Department. 

1040.  Dental  officers  will  not  be  released  from  responsibility  for  the  loss  or 
ilestruction  of  property  placed  in  their  chai-ge  unless  the  expenditure  is  au- 
thorized by  the  bureau  or  by  a  board  of  survey. 

1041.  In  the  survey  of  dental  property,  transfer  of  stores  and  property 
accountability,  dental  officers  will  be  governed  by  and  follow  the  instructions 
relating  to  m'edical  stores.  (See  pars.  2961-2978,  inclusive,  and  ch.  21,  as  well 
as  instructions  on  the  forms  in  u.se.) 

1042.  A  supply  of  towels  and  operating  aprons  will  be  furnished  tlie  dental 
officer  by  the  me<iical  department  of  the  ship  or  station  to  which  he  is  attached. 
The  washing  of  the.<;e  articles  will  be  included  in  the  medical  department 
laundry  of  the  ship  or  station  concerned. 


CHAPTER  7. 


THE  DUTIES  OP  THE  FLEET  AND  THE  DIVISION   SURGEON. 

"Section  l.—tAws' ^Relating  to  Appointment  and  Defining  Duties  of  Fleet 

SURGEqjSTj,;    ^,^ 

1101.  Surtreou  of  the  fleet  appoiuted.    Sec.  1373,  R.  S. 

1102.  Duties  of  surgeou  of  the  fleet.    Sec.  1374,  R.  S. 

Section  2.— Navy  Regulations  Relating  to  the  Fleet  Surgeon. 

1111.  Officers  composing   commauder   iu   chiefs   staff,   and   how   designated. 
.     R  1816-1828. 

1112.  Embarked  iu  flagship.     R  1827. 

1113.  To  iuspect  ship  only  when  ordered.    R  182&. 

1114.  General  duties.     R  1818.  v.. ,(5    r-Myu"    >■■■ 

.j,„;'^,;,.:,Section  3.— The  Staff  of  a^Flag  Officer  AjfLOAa;jO}^;%^Gf^,|)'t'^f  i ,  ;•,' 

,' ■       ,.    .  ■  ,,.■    .,.-•,    •}•■■.   ■-»/,    <-io,:tn<v.Mrvn   c,-'::t:-','i'r  k      .hovi'  '' .■ 

"'    1121.  Organization.     R  1846  (1). 

1122.  Nomination  of  ofiicers.     R  1846  (2). 

i, I •;, ;^EGTp^  ;^—NAy-s^ /Instructions   Relating  to  ti^e;.  Fleet   Surgeon. 

1131  Reouisitions  and  correspondence  (staff).     I  1121  (1-2). 

1132  DuUes    of    fleet    surgeon,    and    inspections    of    medical    departments. 

I  1122   (2). 
1133.  Sanitary  inspections.    I  1122  (3). 
_,  113-1.  Consultation  ',vith  medical  oflicers     I  1122  (4).  i,-^ 

1135.  Suggestions  to  commander  in  chief.    I  1122  (5)  ,  1  9,3^, ,(,4)- 

1136.  Inspection  of  naval  hospitals.     I  1122  (6). 

1137.  Report  of  killed  and  wounded.    11122(7). 

113S    Sanitary  report  and  approval  of  official  reports  and  returns.     I  916 
;V  (4)  d.;  11122  (8). 

A- 1139.  Papers  referred  by  chief  of  staff..    I  53.3o  ^^v .,_  ,„, 

1140.  Reports  submitted  to  commander  in  chief.    1  oZlZ  (^). 

Section  5— Reportjs  from  Ships  Returnable  Through  or  Forwarded  to  Com- 

■'.'       .  ■  MANDER   in    CHIEF   AND   FLEET    SURGEON. 

1141.  Certificates  Of  death.    R  2963  (1)  ;  I  1122  (8). 

-    1142.  Reports  of  medical  survey.    I  1122  (8)  onpor-^ 

.'     1143.  Patients  transferred  to  hospitals  other  than  naval  hospitals.    R  2962(y). 
1144*  Property  returns  from  ships.    I  32.J.5  (4). 
1145    Weekly  reports  of  sick,  hospital  ships.     (Duplicate.) 
1146*.  Sanitary  reports  (duplicate)  and  monthly  sanitary  reports. 
1147*.  Reports  of  epidemic  diseases. 

1148.  Surveys  of  medical  property.      rkal  IbvbVI  baa  gaoiirJi/soH  yyaVL 

1149.  Statistical  reports.     (Duplix.'tite4b  sri*  hnu  1^«la  nofgiv!'-  -' •'     'I  ft 


ihltl    .Tin??  noiaivib  lo 


71,7 


72  MANUAL  FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

1150.  Venereal  prophylaxis.     (Monthly.) 

1151.  Casualty  report  when  necessary. 

1152.  Keports  of  laboratory  examinations. 

1153.  Reports  of  surgical  operations. 

1154.  Periodical  returns  when  ship  Is  separated  from  commander  in  chief. 

I  5335  (5). 

1155.  Medical  services  rendoi-ed'  to  other  than  naval  personnel. 

Section  6. — Miscei-laneous  Duties  of  the  Ft.eet  Suiigeon. 

1161.  Brigade  surgeon:  A  force  of  the  strength  of  the  fleet  brigade  will 
usually  be  landed  only  for  parades  and  reviews.  The  fleet  surgeon  is  usunlly 
detailed  on  these  occasions  as  the  brigade  surgeon,  with  a  chief  pharmacist's 
mate  as  his  noncommissioned  staff  petty  officer.  For  detailed  duties  of  fleet 
surgeon  as  brigade  surgeon  see  Chapter  10,  section  3.  (See  also  Fleet  Regu- 
lations.) 

1162.  Inspection  of  ships  (commander  in  chief  and  division  commander's 
Inspection)  :  Information  is  called  for  in  the  inspection  reports  under  the  fol- 
lowing heads :  Size,  arrangement,  cleanliness,  and  order  of  sick  bay.  Condition 
of  surgical  instruments.  Adequacy  of  medical  and  surgical  facilities  for  re- 
quirements of  action  and  coping  with  a  contagious  disease.  Condition  of  medi- 
cal storerooms  as  regards  cleanliness,  good  order,  and  state  of  preservation  of 
articles  stored  therein,  and  when  the  storeroom  was  last  broken  out.  Efliciency 
of  organization  and  administration  of  the  Medical  Department  and  whether 
calculated  to  give  the  best  of  care  to  the  sick.  Efficiency  of  medical  attendants 
and  whether  they  are  fully  instructed  in  their  duties.  Adequacy  of  the  sick 
bay  in  size  and  equipment,  and  of  the  supply  of  medicines,  instruments,  etc. 
Sanitary  condition  of  the  ship.  Adequacy  of  hygienic  regulations,  and  whether 
enforced.  Average  percentage  of  sick  for  last  12  months.  Percentage  due  to 
injuries  and  to  epidemics.  Number  of  venereal  diseases  during  the  last  12 
month.s.  Facilities  provided  for  prophylactic  treatment  and  what  treatment 
is  provided.  Whether  the  men  have  been  regularly  instructed  in  tirst-aid.  sani- 
tary matters,  and  resuscitation  of  the  apparently  drowned,  and  what  number 
are  instructed  at  a  time.  Whether  the  professional  treatment  of  the  sick  as 
shown  by  health  records  is  efficient,  and  whether  health  records  are  properly 
kept.  Whether  the  provisions  of  the  Navy  Regulations,  Naval  Instructions,  and 
Manual  for  the  Medical  Department  as  regards  instruction  of  the  Hospital 
Corps  have  been  complied  with.  Percentage  of  men  vaccinated  within  a  year 
and  whether  the  regulations  regarding  vaccination  are  observed.  Cleanliness 
of  clothing  and  bedding  of  patients.  Whether  the  medical  ofliccr  exercises  any 
supervision  over  the  food  prepared  for  the  cre.w,  the  sick,  and  in  bumboats. 
Whether  the  regulations  regarding  the  storeroom  are  carried  out.  Whether 
the  arrangements  for  the  care  of  the  wounded  in  action  are  carried  out.  Con- 
dition of  Medical  Department  books,  whether  properly  kept,  when  the  last 
inventory  was  taken,  and  whether  the  books  were  then  brought  to  agree  with 
the  inventory.  Whether  blowers  are  well  placed,  well  adapted,  and  adequate. 
Wiiether  all  parts  of  the  ship  are  well  ventilated  in  port,  at  sea  in  bad  weather. 
In  action,  and  the  maximum  and  minimum  temperatures  (ships  newly  com- 
missioned). Changes  recommended  in  ventilating  system  and  in  other  hygienic 
directions. 

1163.  The  fleet  surgeon  should  from  time  to  time  issue  to  medical  of!i<ers 
of  tlie  fleet  a  biflletin  containing  such  information  regarding  epidemic  diseases, 
sanitary  measurps  to  be  taken,  health  of  port,  etc.,  as  might  otherwise  not 
come  to  their  notice. 

Section  7. — The  Division  Surgeon. 

Navy  I{egulations  and  Naval  Instructions  relating  to  the  division  surgeon. 

1171.  Tlic  division  stalT  and  the  division  surgeon.    R.  1841  (1)    (2). 

1172.  Duties  of  division  staff.     I  1141  (2). 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.  73 

t<i)  The  medical  officer  of  the  division  flagship  shall  be  the  division  surgeon. 
If  the  flag  of  the  division  commander  is  transferred  the  medical  officer  of  the 
new  flagship  shall  assume  the  duties  of  division  surgeon  unless  such  transfer 
is  temporary  and  for  a  short  time  only.    R  1841  (2). 

(6)  The  members  of  a  division  staff  shall,  within  the  division  to  which  they 
are  attached,  perform  their  duties,  as  far  as  applicable,  in  accordance  with  the 
requirements  of  the  following  articles;  for  the  division  surgeon.  R  1827  and 
I  1122;  I  1141  (1). 

1173.  Reports  to  be  submitted  to  the  division  commander.     15214  (2). 


CHAPTER  8. 


THE    ADMINISTRATION   AND    INTERNAL    ORGANIZATION    OF    NAVAL 
HOSPITALS.     SPECIAL  HOSPITALS. 

Section  1. — Laws  Relating  to  the  Establishment  and  Management  of  Naval 

Hospitals. 

1201.  Superintendence  of  naval  hospitals.     Sec.  4S07,  R.  S. 

1202.  Deduction  from  pay  of  officers,  etc.,  for  hospital  fund.     Sec.  4808,  R.  S. 

1203.  Appropriation  of  fines.     Sec.  4809,  R.  S. 

1201.   Disposition  of  forfeitures  for  desertion.    Act  .luue  7,  1900. 

1205.  Purchase  and  erection  of  naval  hospitals.     Sec.  4810,  R.  S. 

1206.  Government  of  naval  asylum.     Sec.  4811,  R.  S. 

1207.  Pensions  of  seamen,  etc.,  at  naval  hospital,  how  paid.    Act  Mar.  3,  189l>. 

1208.  Closing  of  hospitals.     Act  Mar.  3,  1883.  • 

1209.  Hospitals,   buildiniis,    and   sites  to  be   authorized  by   Congress.     Act 
IMarch  4,  1913. 

Section  2.— Navy  Regulations   Relating  to  the- Administration   of  Naval 

Hospitals. 

1211.  Removal   of  sick  to  hospital   may   be  made  whenever  recomraendeu. 
R  4.5.32  (1)  ;  R  3582  (1). 

1212.  Tuberculosis  cases.     R  3.582  (2). 

1213.  Pay  of  enlisted  men  while  in  hospital.    R  4532  (2)  ;  R  3582  (3-8). 

1214.  Patients   transferred    to   Naval   Hospital,    Phihidelphia,    to   report   t(* 
governor  of  Naval  Home.     R  3582  (0). 

1215.  Transfer  papers.     R  3585. 

1210.  Payments  to  patients  in  hospital.     R3GGD  (5). 

1217.   Officers  and  men  entitled  to  hospital  treatment  when  no  naval  hospital. 
R  4-532  (1). 

Section  3. — Naval  Instructions  Relating  to  the  Administration  of  Naval 

Hospitals. 

1221.  Officers  transferred  to  hospitals  and  when  they  return  to  duty  to  be 
reported  upon.     I  956. 

"'      (a)   Entitled  to  remain  until  cured  or  surveyed.     I  3221  (1). 

(b)  When  discharged,  if  still  disabled  may  go  to  Naval  Home.    I  3221  (2). 

(c)  Papers  in  such  cases  to  go  to  the  Secretary  of  the  Navy.    I  3221  (3). 

1222.  Sick,  wounded,  or  disabled  officers  entitled  to  medical  attendance.     1 
S222. 

1223.  Responsibility  of  medical  officer  in  command.     13223. 

1224.  No  changes  to  be  made  in  buildings,  trees,  or  grounds.    13224. 

1225.  Inspection  of  medicines,  supplies,  etc.     I  3225. 

1226.  Examination  of  healtli  records.     I  3226. 

1227.  Medical  officer  of  the  day. 
(a)  Detail.     I  3227  (IL 

(&)   Dailv  journal.     I  3"227  (2). 
(c)   Duties.     I  3227  (3). 


76  MANUAL   FOR   THE   MEDICAL   DEPARTMENT,    U.    S.    NAVY. 

1228.  Medical  oJlkers  in  charge  of  wards.     13228. 

1229.  Patients  to  be  accompanied  by  liospital  tickets  and  liealUi  records  I 
3229. 

1230.  Convalescents  to  be  di.scharged  when  fit  for  duty.     I  3230. 

1231.  Attendants  of  hospital  alone  available  for  service  to  patients.     I  323L 

1232.  Diet  tables,  and  variations  authorized.     13232. 

1233.  Special  diet  list  to  be  revised  daily.     13233. 

1234-.   Forms  to  be  observed  upon  receipt  of  patients.     13234. 
1235.  Patients  left  in  hospital  after  sailing  of  ship.    I  323-3. 
1230.  Discharges  for  disability. 

(d)   Upon  approved  medical  survey.     I  3236  (1). 

(b)   Name  of  ship  to  be  noted  in  survey.    I  3236  (2). 
1337.  Health  records  of  persons  surveyed  to  be  signed  and  verified.    13237. 

1238.  Weekly  i-eport  of  sick  in  triplicate.     I  323S. 

1239.  General  regulations  for  government  of  hospitals  to  be  submitted  to 
Secretary  of  the  Navy  and  included  in  Manual  for  the  Medical  Department.  De- 
tailed regulations  for  internal  government  of  hospitals  issued  by  medical  officer 
in  command.     I  3239. 

1240.  Ambulance  service  for  in.jiired  civil  employees.    13411  (1). 

1241.  Treatment  of  civil  employees  in  naval  hospital.    13411  (2). 

1242.  Misconduct  report.     I  5247  (62).     Gen.  Ord.  No.  100  and  231. 

Section  4. — General  Instbuctions  Relating  to  Naval  Hospitals. 

1251.  Commander  in  chiefs  inspection.     1908. 

1252.  Fleet  surgeon's  inspection.     11122  (6). 

1253.  Hospital  to  keep  ti  journal.    I  3251. 

1254.  Hospital  records  to  be  kept  with  neatness  and  accuracy.     I  32.V2. 

1255.  Issue  of  medicines,  etc.,  to  persons  not  in  Navy  to  be  entered  in  pre- 
scription book.     I  3253. 

1256.  List  of  patients  for  use  in  compiling  statistical  report.     13254. 

1257.  Property  accountability.     13255. 

1258.  Bill  book.     I  3258. 

1259.  Sanitary  report  from  hospitals.     I  3259. 

12G0.  All  persons  employed  in  Medical  Department  prohibited  from  having 
financial  dealings  with  patients.     1.3260. 

12<)1.  Hospital  and  ambulance  service  to  be  performed  by  Hospital  Corps. 
1  3261. 

1262.  Correspondence  of  naval  hospital  to  be  conducted  as  if  a  yard  depart- 
ment.    I  5340  (9). 

1265.  A  person  under  treatment  for  a  period  of  three  months  shall  be  sur- 
veyed in  order  tliat  his  further  treatment  or  other  disposition  may  be  authorized, 
and  in  order  that  the  bureau  may  have  information  as  to  the  necessity  for  such 
prolonged  treatment. 

1266.  Care  should  be  taken  that  all  convalescents  are  promptly  returned  to 
duty. 

1267.  No  enlisted  man  under  sentence  of  general  court-martial  to  he  sent  to 
Naval  Hospital,  Fort  Lyon,  Colo.,  for  treatment.  (Department  decision,  No. 
26251-6590,  Apr.  14,  1913.) 

1268.  Otiicers  and  men  of  the  Naval  Militia,  though  they  receive  the  same 
Iiay  while  on  naval  duty  as  those  in  the  Kegidar  Navy,  have  no  (knluctiou  made 
from  their  pay  for  the  Naval  Hospital  Fund  (Sec.  4S0S,  K.  S.),  and  are  ni>r  en- 
titled, under  the  provisions  of  law,  to  treatment  and  subsistence  in  naval  hos- 
l)itals,  (Sees.  4808,  4812,  4813.  H.  S.,  and  comptroller's  decision  of  Aug.  25. 
1914)  except  when  incorporated  with  the  Navy  in  time  of  war. 

1276.  <3ivil  employees:  Subsistence  while  in  a  naval  ho.spital.  Notices  of 
admission  and  discharge,  M.  &  S.,  Forms  "S"  and  "  T,"  .shall  be  forwarded  by 
the  oflicer  in  connnand  of  the  naval  h(»s;)ital  to  the  paymaster  of  the  yard,  who 
shall  receive  from  the  patient  tlie  50  cents  for  each  day  or  part  of  day  in  ho.s- 


MANUAL   FOR  THE    MEDICAL  DEPARTMENT,  U.    S.    NAVY.  77 

pital,  giving  his  receipt  therefor,  and  shall  deposit  same  to  the  credit  of  the 
naval  hospital  fund.  ^       , 

In  cases  where  payment  is  not  made  within  a  reasonable  time,  or  of  a  refusal 
to  make  payment,  a  sum  sufhcient  to  cover  same  shall  be  withheld  from  any 
pay  due  the  employees,  and  a  full  report  of  the  circumstances  shall  be  made  to 
rhe  Bureau  of  Supplies  and  Accounts.      (Bur.  S.  &  A,  Memo.,  No.  131,  Feb. 

'  12 t"?.  Commanding  officers  of  certain  hospitals  designated  by  the  Secretary 
of  the  Navy  are  autiiorized  by  the  act  of  August  29.  1916,  to  order  summary 
and  deck  courts-martial  and  to  inflict  minor  punishments  upon  all  enlisted  men 
attached  thereto,  whether  for  duty  or  as  patients,  as  conferred  by  law  upon  the 
oonnnander  of  a  naval  vessel.  >: 

1278.  Medical  officers  in  command  of  naVal  hospitals  and  hospital  ships  arp 
authorized  to  act  as  recruiting  officers  for  the  Hospital  Corps,  and  for  ref- 
enlisting  and  extending  enlistments  of  other  men  in  the  Navy  who  may  be 
patients  under  their  command.  They  are  authorized  to  administer  oaths  for 
the  purposes  of  the  administration  of  naval  justice  and  for  other  purposes; ;o| 
naval  administration. 

Section  5. — Dutiks  of  the  Medical  Officer  in  Command. 

]\joTE. — The  following  instructions  are  issued  for  the  guidance  of  medical 
officers  in  command  of  hospitals  (and  hospital  ships  when  applicable  (R  2919) ) 
and  shall  govern  in  all  ordinary  circumstances.  Any  situation  requiring  a  de- 
parture from  these  instructions  will  be  made  the  subject  of  immediate  report 
to  the  bureau. 

1281.  The  Navy  regulations  require  that  the  medical  officer;  in  command 
of  a  naval  hospital  shall  be  responsible  for  the  care  and  treatment  of  the  sick, 
and  for  the  discipline,  cleanliness,  and  economical  management  of  the  istitu- 
tion.  The  regulations  further  require  that  medical  officers  and  all  persons  em- 
ployed in  the  hospital  shall  perform  such  duties  as  shall  be  assigned  them  by 
the  medical  officer  in  command,  and  to  this  end  he  is  required  to  exact  from 
subordinates,  employees,  and  patients  a  proper  obedience  to  his  orders  and  to 
the  laws  and  regulations  of  the  Navy.     (I  3223.) 

1282.  All  general  regulations  shall  be  approved  by  the  Secretary  of  the  Navy 
and  included  in  the  Manual  for  the  Medical  Department,  and  all  detailed  regu- 
lations relating  to  the  internal  government  of  the  hospital  of  which  he  is  in 
command  shall  be  submitted  to  the  bureau  as  soon  as  issued.     (I  3239.) 

1283.  The  regulations  require  that  except  in  emergency  no  change  shall  be 
made  in  the  hospital  buildings,  furniture,  trees,  or  grounds,  and  no  bills  for 
purchases  and  repairs  shall  be  contracted  without  the  permission  of  the  bureau, 
except  in  special  exigency.     (I  3224.) 

1284.  The  medical  officer  in  command  is  required  by  the  i-egulations  to  have 
all  medicines,  provisions,  and  medical  supplies  received  at  the  hospital  inspected 
and  their  condition  reported  to  him  by  the  officer  intrusted  with  the  duty.  A 
record  of  such  inspections  shall  be  entered  in  the  daily  journal.  (I  3225.)  He 
shall  require  the  executive  surgeon  to  make  a  daily  report  on  the  condition  of 
patients  and  on  other  matters  of  interest  pertaining  to  the  hospital. 

1285.  Once  a  week,  or  oftener  if  he  should  deem  it  neces.sary,  he  shall  make 
a  thorough  inspection  of  the  hospital  buildings  and  grounds.  All  matters  of 
interest  brought  to  his  attention  during  his  tour  of  inspection,  and  requiring 
subsequent  action,  shall  be  noted  and  recorded  in  a  book  kept  for  this  purpose 
by  the  executive  surgeon.  The  provisions  of  Article  I  2602  (5-6)  shall  be  ob- 
served as  far  as  possible  in  hospitals,  and  inspections  and  musters  shall  not  be 
carried  out  on  Sunday.  The  medical  officer  in  command  shall  assign  appro- 
priate punishment  for  offenses  committed,  such  punishments  to  be  noted  against 
the  offenses  in  the  report  book  and  in  the  journal. 

1286.  (0)  He  shall  see  that  the  regulations  relating  to  the  admission  and  dis- 
charge of  patients  from  the  hospital  and  the  preparation  of  all  official  papers 


78  MANUAL    FOi;    THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY. 

are  strictly  compiled  with.  He  shall  inspect  aud  approve  health  records  and 
assure  himself  that  they  ;iri'  properly  kept. 

(b)  A  per.son  under  treatment  for  a  period  of  three  months  shall  be  surveyed 
iu  order  that  his  further  treatment  or  other  disposition  may  be  authorized,  and 
in  order  that  the  bureau  may  have  information  as  to  the  necessity  for  such 
prolonged  treatment. 

(r)  Care  should  be  taken  that  all  convalescents  are  promptly  returned  to  iluty. 

1287.  The  commanding  officer  shall  keep  himself  Informed  of  the  iiroI)able 
necessity  for  the  performance  of  major  surgical  operations,  and  ludess  there  are 
urgent  reasons  to  the  contrary,  no  operations  of  this  class  shall  be  performed 
without  his  approval.  He  shall  see  that  the  junior  medical  officers  attached 
to  the  hospital  are  afforded  ample  opportunity  for  practical  surgical  work. 

1288.  lie  shall  see  that  the  menjhers  of  the  Hospital  Corps  are  thoroughly 
drilled  and  instructed  in  their  duties.  Whenever  a  member  of  the  Hospital 
Corps  is  transferred  to  other  duty,  either  ashore  or  afloat,  he  shall  cause  a 
Hospital  Corps  efficiency  report.  Bureau  of  Medicine  and  Surgery  form,  to  be 
filled  out  and  forwarded  through  official  channels  to  the  Bureau  of  Medicine  and 
Surgery.  Whenever  changes  occur  in  the  Hospital  Corps,  by  transfer,  death, 
discharge,  etc.,  a  mailing  card  shall  be  forwarded  direct  to  the  bureau. 

1289.  He  shall  cause  the  Hospital  Corps  to  be  instructed  and  e.xercised  not 
less  than  once  every  week  in  fire  drill,  and  shall  see  that  every  facility  is 
afforded  for  the  protection  of  the  hospital  buildings  and  'other  buildings  in  the 
hospital  inclosure  from  lire. 

1290.  (m)  The  medical  officer  in  command  shall  carefully  observe  the  uni- 
form regulations  and  require  all  officers  under  his  conun.iU(l  to  be  in  uniform. 
This  requirement  shall  apply  to  officers  on  duty,  officers  who  are  patients  when 
practicable,  and  to  members  of  the  Ilosjiital  Coips  and  Nurse  Cor])s. 

(b)  He  shall  .see  that  Hospital  Corp.;nien  wear  the  cap  ribbon  designating 
the  hospital  under  his  command. 

1291.  He  shall  submit  to  the  bureau  o-i  the  1st  of  January  of  each  year  a 
sanitary  report,  with  an  appendix  covering  "Public  Works."  (See  par.  2G.'31 
(b).)  He  shall  keep  him.self  informed  regarding  all  changes  proposeil  or 
authorized  by  the  bureau  in  order  to  present  them  clearly  to  the  commandant 
or  to  tlH>  heads  of  departments  concerned.  ■  .  ,. 

1292.  The  list  of  headstones  for  unmarked  graves  in  naval  cemeteries  shall 
be  subinittetl  direct  to  the  l^ircnin  annually  on  .Tuly  1  in  duplicate.      (I  r)24T  (8).) 

1293.  In  hos|iitals  where  there  are  but  two  medical  officers,  the  officer  iu 
conunand  shall  take  under  his  supervision  the  inventory,  the  commissary 
ledger  and  bill  book,  the  cemetery  record,  re(iuisitit>ns  and  bills,  and  the  super- 
vision of  grounds  and  outbuildings.  The  junior  officer  shall  kee]t  the  profes- 
sional records,  supervise  the  preparation  of  ll.e  required  returns,  and  he 
respon.sible  for  the  cleanliness  and  good  order  of  the  hospital  buildings,  and 
perform  such  other  duties  prescribed  for  an  executive  surgeon  as  may  be 
delegated  to  him  by  the  officer  in  command.  The  pharmacist  shall  act  as  the 
relief  officer  of  the  .lay  for  the  purpose  of  preserving  di.scipline  and  for  the 
rec<Mpt  of  stores  and  j)atients. 

1294.  All  the  medical  officers  attached  to  a  hosi)it:d.  when  there  are  three  or 
more,  shall  never  be  absent  from  the  iiremises  at  the  same  time.  When  both 
medical  officers  of  a  hospital  to  which  only  two  are  attached  are  compelled 
temporarily  to  be  absent,  the  i>harmacist  shall  act  as  officer  of  the  day. 

1295.  The  commanding  officer  shall  innuf^diately  inform  the  connnandaut  of 
the  station  and  the  department  (Bureau  of  Medicine  and  Surgery)  of  any 
death  in  the  hospital;  he  shall  iu  addition  inform  by  telegraph  the  next  of 
kin,  family,  or  legal  representative  of  the  deceased. 

Section  6, — Dutiks  of  the  ExKctrrivE  Surgeon, 

1.101.  The  medicHl  officer  attached  to  a  usual  hospital  uext  in  rank  to  tlie 
medical  officer  in  command,  uide.ss  detailed  to  perform  special  duty  only,  is  to 
be  considered  the  executive  surgeon  of  the  hospital,  and,  under  the  direction 


MANUAL   FOR   THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.  79 

of  the  medical  officer  in  cominand,  he  shall  be  responsible  for  the  general  nian- 
asenient  of  the  institution.  He  shall  make  himself  familiar  with  all  laws, 
regulations,  rules,  and  instructions  relating  to  the  administration  and  internal 
government  of  hospitals,  and  see  that  they  are  complied  with. 

1302.  The  executive  surgeon  shall  have  such  authority  under  the  medical 
officer  in  command  as  may  be  delegated  by  the  latter.  He  shall  firmly  and 
faithfully  execute  the  orders  of  the  medical  officer  in  command,  and  shall  keep 
himself  informed  of  his  wishes  in  matters  of  duty,  and  carry  them  out  scrupu- 
lously and  energetically.  He  shall  execute  all  details  of  organization,  police, 
inspection,  and  discipline,  and  shall  be  responsible  to  the  medical  officer  in 
command  for  the  cleanliness,  good  order,  and  preservation  of  buildings  and 
grounds,  and  do  his  utmost  to  render  all  departments  of  the  hospital  efficient. 
He  shall  personally  supervise  all  work,  repairs,  etc.,  that  may  be  done,  and 
report  to  the  medical  officer  in  command  as  to  their  progress. 

1303.  Except  when  excused  by  the  medical  officer  in  command,  he  shall  always 
be  on  duty  when  in  the  hospital,  and  when  on  duty  shall  receive  all  orders 
relating  to  the  general  duties  of  the  hospital  directly  from  the  medical  officer 
in  command  and  transmit  them  to  others  as  may  be  necessary,  and  be  responsi- 
ble for  their  execution. 

1304.  He  shall,  under  instructions  from  the  medical  officer  in  command  and 
the  <n-ders  of  the  commandant  of  the  station,  prescribe  from  day  to  day  the 
uniform  to  be  worn  by  officers  and  enlisted  men. 

1305.  lie  shall  exercise  a  general  supervision  over  the  junior  medical  officers, 
members  of  the  Nurse  Corps,  members  of  the  Hospital  Corps,  and  employees, 
and  report  to  the  medical  officer  in  command  any  inefficiency,  inattention  to 
duty,  infraction  of  discipline,  or  insubordination.  The  executive  surgeon  shall, 
In  conjunction  with  the  chief  nurse,  assign  all  nurses  to  duty,  assignments  so 
made  to  be  subject  to  the  appx'oval  of  the  medical  officer  in  command. 

1306.  He  shall  have  general  supervision,  uiider  the  dii-ection  of  the  medical 
officer  in  command  of  the  hospital,  of  all  patients,  and  keep  himself  informed 
of  their  condition,  and'  report  matters  of  interest  concerning  them  to  the 
medical  officer  in  command.  If  a  sufficient  number  of  medical  officers  is 
attached  to  the  hospital,  the  executive  surgeon  shall  not  be  required  to  take 
personal  charge  of  patients.  If  there  is  not  a  sufficient  number  of  medical 
officers,  he  shall  have  charge  of  officer  patients  and  of  such  others  as  may  be 
assigned  by  the  medical  officer  in  command. 

1307.  He  shall  hold  himself  in  readiness  at  all  times  to  consult  with  and 
advise  the  junior  medical  officers  with  regard  to  patients  under  their  charge, 
and  to  direct,  if  he  deems  it  necessary,  the  treatment  of  such  patients.  Con- 
flicts of  opinion  regarding  treatment  shall  be  referred  to  the  medical  officer  in 
command  for  decision. 

1S08.  He  shall  inspect  dally  the  hospital  buildings  and  the  grounds  and 
buildings  in  the  hospital  reservation,  and  see  that  they  are  in  order  and  report 
their  condition  to  the  medical  officer  in  command.  At  inspections  he  shall  be 
accompanied  by  the  junior  medical  officers  through  their  respective  wards,  his 
attention  being  called  to  any  important  change  or  matter  of  professional  intei- 
est  tliey  may  have  observed  in  their  patients.  ; 

1399.  He  shall  suppress  disorder,  correct  abuses,  and  prevent  violations  of 
discipline  and  report  to  the  medical  officer  in  command  any  infractions  of  dis- 
cipline on  the  i^art  of  employees  or  others. 

•  1810.  He  shall,  inuler  the  direction  of  the  medical  officer  in  command,  grant 
permission  to  the  junior  medical  officers  and  others  to  leave  the  premises,  such 
leave  not  to  extend  beyond  8.30  a.  m.  of  the  following  day. 

1311.  He  shall  direct  the  issue  of  passes  to  all  enlisted  men  and  employees 
to  whom  liberty  may  be  granted,  and  such  passes  are  to  be  delivered  upon  the 
return  of  the  bearers  to,  the  gatekeeper  or  orderly  at  the  door,  who  shall  note 
noon  them  and  in  the  liberty  book  the  time  of  return  and  condition  of  the  men. 
The  executive  surgeon  shall  have  these  passes  and  the  liberty  book  delivered  to 
liini  at  a  designated  time  for  his  approval.  Pass  books  will  be  supplied  by  the 
bureau  upon  application. 


80  MANUAL  FOR   THE   MEDICAL  DEPAliTMENT,   U.    S.    NAVY. 

1S12.  He  shall  report  promptly  all  absentees  without  leave  or  over  leave  to 
the  medical  oflicer  in  command. 

1313.  lie  may,  under  the  direction  of  the  medical  officer  in  command,  detail 
convalescent  patients  for  light  work,  hut  no  patients  having  venereal  disease 
tuberculosis,  or  any  oiTensive  or  contagious  disease  shall  be  assigned  to  duty  in 
the  kitchen  or  as  attendants  upon  other  patients.  No  patients  shall  be  re- 
tained in  the  hospital  after  they  are  fit  to  perform  the  duties  of  their  ratines 
(I  3230.)  *  ■ 

1314.  He  shall  exercise  a  supervision  over  the  preparation  of  returns,  re- 
quisitions, bills,  etc.,  and  see  that  they  are  submitted  to  the  medical  officer  In 
command  for  approval. 

1315.  He  shall  see  that  the  medical  officer  in  charge  of  the  operating  room 
and  its  appurtenances  has  everything  in  readiness  for  immediate  use,  that  the 
instruments  are  in  good  condition,  that  ample  dressings  are  prepared,  and  that 
the  sterilizing  apparatus  is  in  efficient  working  order.  He  shall  report  all  de- 
fects in  operating  room  and  apparatus  to  the  medical  officer  in  command. 

1316.  He  shall  require  that  the  officers  in  charge  of  infectious  disease  and 
isolation  wards  and  buildings  and  psychopathic  wards  be  responsible  for  their 
condition  and  in  readiness  for  the  reception  of  patients.  He  shall  see  thar 
special  care  is  taken  in  the  treatment  and  safekeeping  of  all  insane  patient;- 
and  that  the  clothing  and  effects  of  patients  brought  to  the  hospital  with  in- 
fectious or  contagious  diseases  are  promptly  disinfected.  To  this  end  he  shall 
see  that  the  disinfecting  plant  is  maintained  in  proper  working  order. 

1317.  He  shall  require  that  the  officer  assigned  to  laboratory  work  be  re- 
.sponsible  for  tlie  condition  of  the  laboratory  and  caution  him  to  allow  no  un- 
authorized persons  access  to  it. 

1318.  He  shall  appoint  attendants  upon  the  several  messes,  and  shall  give 
."special  attention  to  the  kitchen,  cooking  utensils,  mess  room,  mess  gear,  and 
mess  furniture,  and  shall  require  the  mess  attendants  to  keep  them  in  good 
order. 

1319.  He  shall  have  supervision  over  the  inventory,  bill  books,  commissary 
ledger,  and  cemetery  record,  and  shall  be  responsible  to  the  medical  oflicer  in 
command  for  their  correctne.ss. 

1320.  He  shall  assign  beds  to  incoming  patients  and  distribute  them  in  such 
a  manner  as  to  allot,  as  far  as  practicable,  equal  numbers  to  the  medical  officers 
in  charge  of  the  several  wards  receiving  patients  of  similar  type. 

1321.  He  shall  see  that  the  fire  apparatus  is  ready  for  instant  use.  and  pre- 
pare a  fire  bill  embracing  officers.  Hospital  Corps,  and  employees  and  such  con- 
valescent patients  as  may  be  available,  and  have  it  posted  in  a  con.spicuous 
place,  making  such  changes  as  may  from  time  to  time  become  necessary,  and  see 
that  all  are  conversant  with  their  stations  by  exercise  at  fire  quarters  at  such 
times  as  the  medical  oflicer  in  command  may  direct. 

1322.  He  shall  require  all  keys  to  be  labeled,  and  when  not  in  use  to  be  bung 
on  a  keyboai-d  in  his  office,  or  otherwi.se  properly  safeguarded. 

1323.  He  shall  make  the  necessary  arrangements  for  all  funeral  services. 

1324.  He  shall,  under  the  diection  of  the  medical  officer  in  command,  see 
tliat  the  cemetery  is  kept  in  good  order. 

1325.  He  shall  see  that  all  meals  are  Inspected  by  the  officer  of  the  day  or 
pharmacist  both  before  and  after  serving,  and  he  should  personally  inspect  the 
meals  frequently,  when  served,  to  assure  hiiii.self  that  the  food  lias  been  i)roperly 
prepared  and  is  of  good  quality  and  of  sulliclent  quantity.  He  shall  from  time 
ro  time  inspect  special  diet  sheets  to  assure  himself  that  proper  economy  is 
i)eing  practiced. 

1326.  He  shall  insjiect  or  cau.se  to  be  Inspected  from  time  to  time  the  clothhig 
and  outfits  of  men  in  the  Ho.spital  C3orps  and  see  that  each  one  has  the  neces- 
sary uniforms  and  that  they  conform  to  the  requirements  of  the  uniform  regula- 
tions. 

1327.  He  shall  .see  that  the  library  Is  kept  in  good  condition  and  that  the 
reading  material,  as  far  as  practlcal)le,  is  available  for  the  use  of  patients.     He 


MANUAL    FOR    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.  81 

shall  see  that  the  Hospital  Corps  and  convalescent  patients  are  provided  with 
athletic  outfits  furnished  hy  the  department,  and  that  they  have  suitable  hours 
for  recreation  and  outdoor  games 

1328.  Subject  to  the  approval  of  the  medical  officer  in  command  he  shall 
arrange  the  time  when  divine  services  may  be  conducted  in  the  hospital,  and 
endeavor  to  obtain  the  services  of  a  chaplain  or  minister  for  patients  desiring 

spiritual  comfort.  .  ...,,,  , 

1329  He  shall  see  that  a  bulletin  board  is  hung  m  a  suitable  place,  where  n 
copy  of  all  orders  and  notices  issued  by  the  medical  officer  in  command  and  all 
general  and  special  orders  shall  be  posted. 

1330.  He  shall  see  that  proper  steps  are  taken  to  safeguard  money  and 
valuables  of  patients  entering  the  hospital. 

1331    He  shall  designate  the  hours  when  visitors  may  see  patients. 

1332.  All  officers  attached  to  a  hospital  shall  wear  the  service  uniform  of 
their  <--rades  at  all  times  when  on  duty  in  the  hospital,  except  at  weekly  inspec- 
tion when  undress  uniform  may  be  worn  if  prescribed  by  the  commanding  offi- 
cer 'or  on  special  occasions  when  the  uniform  shall  be  prescribed.  All  enlisted 
men  of  the  Navv  and  Marine  Corps  shall  wear  the  uniform  of  the  day. 

1333  In  hospitals  where  there  is  one  surgeon  acting  as  executive,  and  one 
nassed'assistant  or  assistant  surgeon  besides  the  officer  in  command,  the  surgeon 
shall  not  be  required  to  alternate  as  officer  of  the  day,  but  shall,  in  addition  to 
his  regular  duties,  take  professional  charge  of  as  many  patients  as  the  officer 
in  commnd  may  direct.  A  pharmacist  shall  be  the  relief  officer  of  the  day 
under  the  restrictions  provided.  _ 

1334  In  hospitals  where  there  are  two  passed  assistant  or  assistant  surgeons, 
or  one  of  each  besides  the  officer  in  command,  the  senior  of  the  two  shall  in 
addition  to  his  regular  duties,  perform  such  other  duties  prescribed  for  the 
executive  surgeon  as  the  officer  in  command  may  delegate. 

1335.  (a)  All  medical  officers  shall  assure  themselves  that  all  drugs  and 
chemicals  under  their  charge  are  properly  labeled.     ,,,.,,  •    ,-     ^    ,  „„ 

(6)  They  shall  see  that  all  poisons,  chemical  or  alkaloidal,  are  indicated  as 
such  bv  appropriate  poison  labels.  ,      ,     ,         i  ,         „„^ 

(c)  Poisons  chemical  and  alkaloidal,  shall  be  kept  under  lock  and  key.  and 
access  to  such  cabinet  or  container  shall  be  had  only  by  the  medical  officer  or 
such  persons  as  are  specifically  designated  by  him.  ■,      ptao  o    « 

((/)  For  dispensing  of  poisonous  solutions  in  sick  bays  or  wards,  500  c.  c. 
bottles  are  furnished,  of  an  appropriate  attention-compelling  color  an(l  design. 

(e)'  Bichlorid  tablets  will  be  issued  only  in  such  form  as  is  furnished  by 
the  supply  ^tljPot._^  further  invited  to  the  desirability  of  tinting  stock  solutions 
of  phenol  or  bichlorid  of  mercury  when  these  solutions  are  P^-epared  in  quantity 
To  insure  uniformity  phenol  will  be  tinted  pink  (fuchsin),  and  bichlorid  will 
he  tinted  hhie  (methvlene  blue).  . 

(g)  Poisonous  drugs  should  be  dispensed  only  on  written  and  signed  pre- 
scription  of  medical  officer,  such  prescriptions  to  be  numbered  and  filed  by  the 
dispenser. 

Section  7— Duties   of  the  Junior  Medical   Officers,  Ward   Officers,   and 
Officers  Having  Special  Duties. 

1341  Junior  medical  officers  shall  perform  such  duties  as  may  be  ^signed 
them  by  the  executive  surgeon  with   the  approval  of  the  medical  officer  in 

^^'l3r2^Thev  «hall  visit  the  sick  at  such  hours  as  may  be  prescribed,  and 
v^henever  necessarv.  They  shall  see  that  the  order  book,  the  property  book,  and 
other  ward  forms  are  properly  kept.  They  shall  consult,  whenever  they  deem 
it  necessarv  with  the  executive  surgeon,  or,  after  notifying  him,  with  the  offic-ei 
in  command,  regarding  patients  under  their  charge.    While  all  reasonable  inde- 

98601°— IT 6 


82  MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

pendence  of  action  in  the  conduct  of  cases  Is  to  be  accorded  them,  if  either  of 
those  officers  shall  direct  certain  measures  his  orders  shall  be  promptly  and 
re.^pectfully  obeyed. 

1343.  They  shall  require  the  nurses  and  Hospital  Corpsmen  to  keep  the  wards 
under  their  charge  clean  and  in  ^ood  order,  to  be  considerate  and  attentive  Ln 
their  treatment  of  all  patients  and  careful  in  the  administration  of  uiedicines. 
and  assure  themselves  that  all  attendants  are  conversant  with  the  rules  issued 
for  theii'  guidance.  Once  a  week,  or  when  directed,  they  will  submit  the  healtli 
records  of  patients  under  their  char;!;e  to  the  commandint;  otflcer. 

1344.  Tliey  shall  direct,  each  morning,  such  special  diet  as  they  may  deem 
necessary  for  the  patients  under  their  charge.  The  special  diet  lists  from  the 
several  wards  are  to  be  submitted  to  the  executive  surgeon.  They  shall  see 
that  a  liberty  list  is  made  out  and  submitted  to  the  executive  surgeon. 

1345.  In  the  e\ent  of  fire,  junior  medical  officers  shall  sujiervise  the  removal 
of  helpless  or  bedridden  patients,  having  the  nurses  and  Hospital  Corpsmen 
under  their  counnand,  and  calling  to  their  aid  any  person  not  specially  detailed. 

1346.  They  shall  report  to  the  executive  surgeon,  or  to  the  officer  in  com- 
mand, all  patients  who  in  their  opinion  are  tit  for  duty,  for  light  work,  or  who 
should  be  surveyed.  They  shall  visit  and  inspect  all  patients  under  their  care 
at  least  twice  daily,  and  oftener  in  cases  requiring  it.  Upon  being  relieved  of 
duty,  the  relieving  officer  shall  verify  the  property  book. 

1347.  Medical  officers  in  charge  of  wards  shall  be  responsible  for  their  good 
order  and  neatness  and  they  shall  exercise  a  personal  supervision  over  the  sick, 
being  attentive  to  their  welfare  and  comfort.  They  will  accompany  the  execu- 
tive surgeon  when  he  makes  the  usual  in.spection  of  wards  and  invite  his  atten- 
tion to  any  important  changes  or  to  matters  of  professional  interest  affecting 
patients  occurring  since  the  previous  inspection. 

1348.  Ward  officers  must  remain  in  the  hospital  until  the  receipt  and  dis- 
tribution of  patients  at  the  regular  ambulance  trips,  except  wlieu  excused  by 
proper  authority.  Before  leaving  the  ward,  after  the  morning  sick  call,  they 
shall  sign  morning  reports  of  sick  and  carefully  inspect  the  diet  sheets  for  the 
day,  making  such  changes  in  the  latter  as  may  be  necessary,  and  after  signing 
forward  them  to  the  pharmacist  (or  chief  pharmacist's  mate)  in  charge  of 
commissary. 

1349.  Officers  having  under  their  charge  wards  for  special  cases  will  be  held 
responsible  for  the  property  under  their  control  and  for  the  proper  performance 
of  the  duties  to  which  they  are  assigned.  Reports  of  work  done  will  be  for- 
warded through  the  executive  surgeon  to  the  commanding  officer. 

1350.  The  medical  officer  detailed  in  charge  of  the  operating  room  shall  see 
that  the  operating  room  and  its  appliances  are  in  readiness  for  immediate  use; 
that  every  precaution  is  observed  to  maintain  instruments  in  good  condition ; 
that  ample  dressings  are  prepared  and  sterilized  ;  and  that  the  sterilizing  appa- 
ratus is  kept  in  efficient  working  order.  He  shall  promptly  report  any  defect  iu 
operating  room  or  apparatus  to  the  executive  surgeon.  He  shall  see  that  an 
operating-room  book,  with  name  of  patient,  nature  and  date  of  operation,  is  kept 
up  to  date.  He  shall  have  supervision  over  the  surgical  ward,  dressings  and 
treatment  of  surgical  cases,  and  shall  consult  with  the  executive  surgeon  regard- 
ing the  nature  of  and  necessity  for  all  operations. 

1351.  The  medical  officer  detailed  for  duty  in  the  laboratory  shall  have  com- 
jjlete  charge,  and  will  allow  no  one  to  have  access  to  or  use  its  equipment  with- 
out his  knowl(>(lge.  A  coniplclo  record  of  all  laboratory  work  will  be  recorded 
and  reports  sent  to  those  desiring  the  results  of  examination,  on  such  forms  as 
may  be  adopted  for  tliis  purpose.  It  will  also  be  his  duty  carefully  to  instruct 
such  subordinates  as  may  be  assigned  to  duty  under  him  in  practical  laboratory 
techni(|ue. 

1852.  ,So  far  as  may  be  practicable,  officers  detailed  for  special  duties  will 
not  be  required  to  perform  other  services. 

1358.  No  officer  of  a  naval  hospital  shall  ever  be  considered  as  having  an 
alternate  "day  off  duty."    The  junior  officers  .shall  alternate  in  dulv  as  ollieer 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.   S.    NAVY.  83 

of  tlie  day  only  for  periods  of  24  hours  as  detailed  by  the  commanding  officer, 
but  such  relief  from  duty  as-  officer  of  the  day  shall  not  in  any  way  relieve  them 
from  their  professional  and  other  duties  at  the  hospital ;  nor  shall  they  fail,  upon 
leaving  the  hospital,  to  inform  the  oiTicer  of  the  day  or  the  relieving  officer  of 
any  direction  of  special  importance  they  may  have  given  regarding  the  patients 
under  their  charge  or  of  the  condition  of  any  patient  who  may  require  special 
attention  during  their  absence. 

Section  8. — Duties  of  the  Officer  of  the  Day. 

1361.  The  term  of  duty  of  the  officer  of  the  day  shall  consist  of  24  hours, 
from  10  a.  m.  At  this  time  the  officer  assigned  as  officer  of  the  day  will  relieve  his 
predecessor,  receiving  from  him  ail  special  orders  and  instructions  pertaining  to 
his  term  of  duty  that  may  be  necessary.  The  oflicer  of  the  day's  office  shall  al- 
ways be  open,  and  except  for  meals  or  when  called  elsewhere  by  duty  the  officer 
of  the  day  shall  give  his  undivided  attention  to  the  official  business  of  the  hos- 
pital ;  he  shall  leave  the  building  on  duty  only,  unless  excused  ))y  special  permis- 
sion of  the  commanding  officer ;  he  shall  be  in  his  office  until  the  9  p.  m.  reports 
are  made ;  and  he  shall  permit  no  loafing  or  lounging  there  by  officers,  patients, 
visitors,  or  others.  The  officer  of  the  tlay  shall  occupy  quarters  in  the  main  build- 
ing during  his  terra  of  duty  and  shall  at  all  times  wear  the  uniform  of  the  day. 
In  the  afternoon  he  shall  make  a  tour  of  inspection  through  the  wards,  kitchens, 
mess,  and  other  rooms  of  the  hospital  occupied  by  patients  and  employees.  A  simi- 
lar inspection  shall  be  made  at  night,  at  10  p.  m.,  after  the  patients  are  in  bed. 
A  list  of  patients  and  employees  who  have  received  passes  shall  be  furnished  the 
officer  of  the  day  as  early  as  practicable  every  morning,  and  all  patients  and 
others  will  be  required  to  report  their  return  to  him.  (I  3227.)  He  shall  sign 
necessary  passes  for  the  removal  of  personal  or  otlier  property  from  the  hospital. 

1362.  The  officer  of  the  day  shall  keep  a  journal  in  which  he  shall  make  a 
brief  record  of  the  following  points  and  events  to  be  noted  at  the  time  of  occur- 
rence :  The  condition  of  the  wards,  kitchens,  mess,  smoking,  and  other  rooms  at 
each  inspection ;  the  condition  of  the  meals  served  as  to  quality  and  quantity ; 
special  trips  of  the  ambulance;  the  names  and  diseases  of  patients  admitted, 
and  the  places  from  which  they  are  received;  the  names,  number  of  days  sub- 
sisted, and  the  disposition  made  of  patients  discharged,  and  whether  the  nec- 
essary papers  in  each  case  are  correct  and  complete;  the  names  and  condition 
of  patients  and  employees  returning  from  leave  or  who  have  overstayed  their 
leave;  the  confinement  and  discharge  of  offenders  and  the  reasons  for  punish- 
ment ;  the  appointment  and  discharge  of  employees ;  the  reporting  and  detach- 
ment of  oflicers,  or  their  going  upon  and  returning  from  leave ;  the  record  of  in- 
spection of  all  provisions,  stores,  and  medical  supplies ;  the  object  and  findings 
of  all  boards  of  survey ;  and  all  other  matters  occurring  during  the  term  of 
duty  which  it  may  be  desirable  to  record.  Upon  completion  of  his  term  of 
duty  he  shall  sign  the  journal  and  submit  it  for  the  approval  of  the  commanding 
officer.  Entries  by  any  other  officer  temporarily  relieving  the  regular  officer  of 
the  day  shall  be  signed  by  the  officer  making  them. 

1363.  Health  records,  the  journal,  and  conduct  records  shall  be  carefully 
supervised  by  the  medical  officer  of  the  day.  He  shall  supervise  the  necessary 
entries  in  the  ambulance  book,  the  register  of  patients,  and  the  rough  Form  F. 

1361.  The  officer  of  the  day,  after  receiving  the  final  reports  at  night,  shall 
report  the  condition  of  the  hospital  to  the  executive  surgeon  or,  in  his  absence, 
to  the  medical  officer  in  command. 

1365.  The  following  regulations  relating  to  the  admission  and  discharge  of 
patients  shall  be  strictly  followed  by  the  oflicer  of  the  day. 

(rt)  When  a  hospital  ticket  is  found  correct,  and  the  clothing  list  checked,  it 
shall  be  filed  and  retained  until  final  disposition  of  patient.  Upon  discharge  the 
patient  shall  sign  tlie  receipt  of  clothing  and  the  receipted  ticket  shall  be  placed 
in  the  files. 


84  MANUAL    FOR    THE    MEDICAL    DEPARTMENT,   U.    S.    NAVY. 

(h)  Eiitor  tlio  name,  etc.,  (1)  in  the  .i,'eiieral  alphal)etical  register  of  patients, 
which  is  ilie  jHTinjint'iit  liospital  record,  for  future  reference;  and  (2)  on  the 
card  al»stract  of  ]»atients.     (Form  F,  rouj^li. ) 

(v)   Inspect  liealth  records  (Form  H),  and  file  in  office. 

((f)  When  a  patient  is  dischai'yed  from  the  hospital  tlie  fact  shall  be  entered 
upon  the  register  of  patients  and  also  upon  the  health  record,  which  is  to  be 
sijined  and  approvetl. 

(r)  When  an  officer  patient  is  admitted  or  discharged,  notice  shall  be  sent  to 
the  office  for  the  preparation  of  leiter  to  Bureau  of  Navigation,  through  com- 
mandant. 

(/)  In  the  case  of  officers  or  men.  when  necessary,  the  misconduct  report 
notice  of  admission  or  discharge  (I  r>247  (61))  shall  be  made  out. 

1360.  The  approved  libi-rty  lisl  will  be  submitted  to  him  and  he  shall  as  far 
as  possible  check  the  same  until  10  p.  m.,  after  which  hour  liberty  men  return- 
ing will  be  checked  in  by  the  person  ilesignated  for  that  pur])ose.  Liberty 
parties  will  have  at  a  stated  hour,  an  J  he  shall  inspect  them  and  see  that  the 
uniform  of  the  day  is  strictly  adhered  to. 

1367.  He  shall  receive  all  patients  admitted  during  his  tour  of  duty,  and 
after  consultation  with  the  executive  surgeon,  assign  them  to  .he  proper  w;u'ds. 
Each  patient  received  shall  have  a  complete  physical  examination  to  determine 
if  any  abnormality  exists  other  than  that  for  which  admitted. 

1368.  He  shall  hold  a  sick  call  in  the  evening  at  the  hour  designated  by  the 
commaniling  officer  and  after  its  com])leti<  n  visit  the  brigs,  if  any  prisoners 
are  confined,  at  which  time  he  shall  oe  accompanied  by  the  master  at  arms, 
who  will  see  that  any  treatment  ordered  is  received. 

1369.  He  shall  make  himself  thoroughly  familiar  with  the  details  of  the 
fire  drill  as  prescribed  in  the  hospital  to  which  he  is  attachetl. 

Section  9. — Duties  of  the  Ph.\kmacist. 

1371.  The  duties  of  the  pharmacist  comprise  all  that  relates  to  the  replenish- 
ment of  supplies,  the  upkeep,  expenditure,  and  survey  of  property,  the  com- 
missary department,  and  the  correspondence  and  clerical  work  of  the  adminis- 
trative office  incident  to  the  above.  He  also  assists  in  the  instruction  of  mem- 
bers of  the  Hospital  ('orps. 

Vov  purposes  of  description  these  duties  may  be  divided  as  follows : 

1372.  Ci.ERirAT.  WORK  IN  THE  ADMINISTRATIVE  OFFICE:  The  office  Work,  when 
practicable,  may  be  divided  into  that  of  personnel  and  material.  The  pharma- 
cist, under  suiiervision  of  tlie  executive  surgeon,  shall  have  charge  of  the 
preparation  of  requisitions  and  public  bills,  the  general  correspondence,  records, 
files,  and  returns. 

All  letters  and  communications  received  are  to  be  catalogued  according  to  a 
coTnprehensi\e  card-index  system,  grouped  under  the  several  bureaus  of  the 
Navy  De]>artment  and  miscellaneous  subjects;  they  are  to  be  cross  indexed 
and  filed  in  ninnbered  .jackets.  All  outgoing  letters,  indorsements,  ration  ad- 
missions and  discbarges,  and  other  communications  of  which  a  permanent 
record  is  desirable,  shall  be  carbon  copied  when  prepared  and  the  copies  care- 
fully ind'^xetl  and  filed. 

(1)  Division  of  personnel  :  This  division  shall  have  charge  of  all  files,  records, 
corresprmdencc.  and  returns  relating  to  the  p(M-sonnel.  lender  this  head  would 
come,  besides  the  usual  reports  and  returns  (see  ch.  24.  sec.  4),  the  following: 
Admis.sion  and  discharge  of  ])atients,  rejiorfs  on  officers  admitted  and  disclmrged, 
fitness  reports,  ration  notices,  entry  of  patients  on  rough  Form  "F,"  filing  of  hos- 
I»itMl  ticlcets.  misconduct  i-cports,  cond<i«-t  reports,  reqtiesfs  and  reports  of  medical 
surveys,  reports  of  death,  death  certificates  (civil  authorities),  conduct  Itook,  re- 
Iiort  an<l  imnisliinent  book,  register  of  ])atieiits.  register  of  dead,  watch  detail, 
liberty  list  and  pass  book,  and  any  other  forms  of  correspondence  affecting  the 
personnel.  When  the  health  rc^cord  is  received  it  shall  be  sent  to  the  office 
after  being  inspected  and  iidtialed  by  the  medical  officer  receiving  the  patient. 


MANUAL   FOR    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.  85 

who  will  also  make  the  appropriate  opening  entries.  The  health  record  is  to 
be  continued  by  entries  made  as  necessary  from  time  to  time  from  clinical 
notes  taken  by  the  ofhcer  on  his  ward  visits.  The  health  record  will  be  retained 
in  the  oftice  in  a  filing  case  provided  for  that  purpose  until  final  disposition  of 
the  case  is  decided  upon.  Disposition  being  «letermined  upon,  the  medical 
officer  in  charge  of  the  case  will,  from  completed  clinical  notes,  make  succinct 
entries  in  health  record  and  close  case.  The  health  record  will  be  available  at 
any  time  for  reference  should  the  medical  officer  in  charge  of  the  ca.se  desire  to 
refresh  his  memory  as  to  the  previous  history  contained  therein  or  to  make 
necessary  entries.  Health  records  opened  in  hospital  will  be  disposed  of  as 
indicated  above. 

(2)   Division  of  material:  This  division  shall  have  charge  of: 
(a)   All  requisitions  and  public  bills. 
(6)   Weekly:  Pay  roll  and  pay  vouchei's  for  civilian  employees. 

(c)  Monthly:  Monthly  pay  roll,   summary   of  pay   roll,   recapitulation  of 

pay  roll,  estimate  of  funds,  statement  of  monthly  expenditures,  and 
monthly  report  of  shipments  made. 

(d)  Quarterly:  Quarterly   bills. 

(e)  Semiannually:  Requisition  every  six  months.  Form  B ;  Form  Ca. 

(/)   Annually  :  ivfaintenance  statement,  sanitary  report,  property  inventory. 

{g)   Bills  of  lading  and  freight  vouchers,  request  for  blank  forms  6n  bu- 

reaiis.    and    any    other   forms,    returns,    reports,    or    correspondence 

affecting  material. 

All  such  official  papers  prepared  in  the  office  shall  be  transmitted  through 

the  executive  surgeon  to  the  commanding  officer  for  final  action. 

1373.  Commissary  DEPAKxirENT:  The  pharmacist  shall  have  direct  supervi- 
sion of  all  matters  pertaining  to  the  commissary  department  of  the  hospital. 
He  shall  submit  daily,  through  the  executive  surgeon,  to  the  commanding 
officer  the  receipt  and  expenditure  vouchers  of  the  preceding  day,  and  he  shall 
keep  a  connuissary  ledger,  which  .shall  be  posted  daily.  He  shall  inspect  all 
stores  and  provisions  on  their  receipt,  noting  their  weight,  condition,  etc., 
and  in  case  any  articles  are  not  satisfactory  he  shall  immediately  notify  the 
officer  of  the  day.  The  latter  officer  is  to  be  notified  of  all  stores  received. 
He  shall  exercise  a  strict  supervision  over  the  preparation  of  food  and  the 
condition  of  mess  halls,  storerooms,  kitchen,  etc.  He  shall  keep  the  executive 
surgeon  informed  of  the  efficiency  of  the  personnel  employed  in  the  culinary 
department,  and  make  such  recommendations  from  time  to  time  as  would 
tend  to  increase  the  efficiency  of  this  department.  He  shall,  through  his  as- 
sistant, issue  all  commissary  stores  required  for  the  daily  use  of  the  hospital. 
The  daily  issue  of  stoi-es  is  to  be  made  in  accordance  witii  the  weekly  bill 
of  fare,  prepared  in  advance,  and  issued  subject  to  the  fluctuations  of  personnel. 
He  shall  pay  particular  attention  to  the  preparation  of  food,  having  in  mind 
economy  and  proper  care  in  preparation  and  service.  He  shall  note  daily 
that  the  individual  service  is  not  excessive.  He  shall  pay  especial  attention 
to  the  cleanliness  of  all  articles  used  in  the  preparation  and  service  of  food. 
All  provisions  will  be  issued  to  the  kitchen  and  to  special  diet  kitchens  by  the 
commissary  department  at  designated  hours.  He  shall  'detatil  all  the  culi- 
nary force,  subject  to  the  approval  of  the  executive  surgeon,  and  shall  report 
to  him  the  absence  of  any  member  of  the  force  under  his  control.  Order  will 
be  preserved  in  mess  halls  by  persons  designated  for  that  purpose. 

(For  detailed  instructions  relating  to  bill  book  and  commissary  ledger  see 
sees.  10  to  14.) 

1374.  Pkoperty  accounting:  Under  the  direct  supervision  of  the  pharma- 
cist the  property  steward  shall  keep  a  card-index  system  which  shall  show  all 
property  on  hand,  except  commissary  stores.  This  system  will  be  subdivided 
to  correspond  with  headings  in  the  bill  book.  No  property  will  be  issued  except 
upon  the  property  accountability  slip,  approved  by  the  executive  surgeon, 
which  shall  be  filed,  after   the  amount  issued,   shown  by  number,  has  been 


86  MANUAL    i'OK    THE    MEDICAL    DEPAJiTMENT,    U.    S,    NAVY. 

tilled  in  under  the  issue  column.  Property  unfit  for  use  and  to  be  surveyed 
will  be  turned  in  to  tne  property  steward  with  property  accountability  slip, 
signed  by  the  executive  surgeon,  showing  under  Uie  survey  column  the  number 
of  articles.  Tlie  signature  of  the  executive  surgeon,  after  careful  inspection 
by  the  property  steward  to  determine  that  the  designation  and  number  of 
articles  turned  in  corre.spond  to  tho.se  on  the  slip,  shall  be  a  warrant  for  him 
to  issue  new  articles  in  kind  and  quantity.  The  completion  of  this  transaction 
w'  be  shown  in  full  or  in  part  by  the  number  placed  in  issue  column.  This 
form  shall  be  always  initialed  before  subniis^'on  to  the  executive  surgeon  by 
the  ward  officer,  head  of  department,  or  other  person  making  the  request. 
All  storerooms  shall  have  a  property  book  in  which  all  articles  on  hand  are 
entered  and  which  .shall  be  posted  from  property  accountability  slips  at  least 
once  a  month.  All  property  on  charge  not  accounted  for  by  storeroom  property 
book,  such  as  furniture,  tools,  etc.,  will  be  found  under  appropriate  headings 
in  the  card-index  system,  and  articles  coming  under  these  headings  that  require 
survey  shall  be  delivered  to  the  property  steward  with  survey  slip,  as  above 
noted.  From  the  data  obtained  from  the  storeroom  property  book  and  card- 
index  system  requisitions  and  surveys  will  be  made.  Property  on  charge 
shall  not  be  transferred  from  one  person  to  another  without  proper  authority. 
He  shall  submit  to  the  executive  surgeon  a  list  of  articles  to  be  siu'veyed  on 
June  1  and  November  1  of  each  year, 

1375.  Hospital  Cokps  Insteuction  :  Subsequent  to  the  course  at  one  of  the 
training  schools  for  the  Hospital  Corjjs,  hospital  corpsmen  will  be  assigned 
to  naval  hospitals  or  to  the  hospital  .ship  for  further  practical  bedside  instruc- 
tion and  practical  application  of  information  received  through  the  school 
course.  Together  with  the.se  men  will  be  those  who  have  changed  rating  to 
the  Hospital  Corps  in  the  second  half  of  their  period  of  enlistment.  These 
latter  men  are  not  assigned  to  Hospital  Corps  training  schools  for  the  pre.sent. 

The  pharmacist  shall  keep  a  record  of  the  names  of  each  one  of  these  men 
and  of  the  instruction  which  is  given  each  man.  This  group  of  men  shall  be 
subdivided  into  smaller  groups  under  the  personal  instruction  of  a  medical 
officer,  the  pharmacist,  or  chief  pharmacist's  mate.  On  such  days  and  at  such 
hours  as  is  most  practicable  each  group  shall  receive  practical  instruction  in 
the  ward,  the  operating  room,  the  di.^pensary,  the  diet  kitchen,  storeroom,  the 
handling  of  records  and  correspondence,  and  the  laboratoi*y.  Practical  dem- 
onstrations of  methods  and  procedures  should  be  given  by  each  instructor,  and 
particular  pains  should  be  taken  to  see  that  any  individual  who  may  not  appear 
to  understand  or  to  be  able  successfully  to  perform  any  act  of  duty  may  receive 
individual  instruction  by  the  insti'uctor. 

The  pharmacist  shall  pay  particular  attention  to  the  practical  instruction 
of  the  hospital  corpsmen  in  operative  pharmacy,  dispensing,  and  Navy  and 
Medical  Department  forms  and  returns.  Such  chief  pharmacist's  mates  and 
pharmacist's  mates,  lirst  class,  who  are  in  the  opinion  of  the  medical  officer  in 
command  deficient  in  knowledge  of  practical  pharmacy,  chemistry,  clerical 
work,  commi-ssary  work,  and  care  of  medical  stores  and  property,  shall  be 
required  to  report  to  tlie  pharmacist  for  instruction  along  these  lines. 

The  instruction  shall  be  so  arrau;:ed  that  when  a  man  reports  at  the  hos- 
pital he  can  inunediately  take  up  the  work.  The  continual  reporting  of  men 
at  more  or  less  frequent  intervals  will  necessitate  the  repetition  of  demonstra- 
tions as  often  as  practicable.  The  point  niust  always  be  kept  in  view  that  in 
training  in  the  hospital  the  practical  work  is  of  paramount  importance. 

The  instruction  .should  be  carried  out  until  the  hospital  corpsman  is  trans- 
ferred to  another  station,  or  until  such  time  when  it  appears,  in  the  opinion 
of  the  instructor,  that  the  hospital  corpsman  has  received  such  a  complete 
rounding  out  of  his  general  information  as  is  consistent  with  his  rating  and 
ability. 

In  general  all  ho.=;pital  corpsmen  will  rotate  in  their  duties  between  the 
medical  and  surgical  wards,  operating  room,  and  di.spcnsary,  in  periods  of  two 


MANUAL   i'OK   THE    MEDICAL   DEPARTMENT,    U.    rf.    NAVY.  87 

months  in  each  ward  and  one  month  in  operating  room  and  dispensary,  and 
except  in  emergency  no  man  will  be  kept  for  a  longer  period  on  any  one  duty 
until  he  has  had  training  in  all  departments. 

It  is  desired  that  such  men  as  show  peculiar  aptitude,  ability,  or  interest  in 
any  one  line  of  work,  such  as  X-ray,  laboratory,  anesthesia,  etc.,  should  receive 
every  possible  opportunity  for  instruction  and  practice  along  the  one  line 
chosen,  in  order  that  there  may  be  developed  within  the  corps  a  certain  number 
of  men  who  are  qualified  along  these  special  lines.  It  is  also  desired  that  the 
names  of  men  who  have  received  this  special  instruction  and  have  these  special 
qualifications  be  submitted  by  the  commanding  officer  to  the  Bureau  of  Medi- 
cine and  Surgery  for  record. 

The  Handy  Book  for  the  Hospital  Corps,  United  States  Navy,  may  be 
obtained  by  requisition  from  the  supply  depot  without  cost  to  the  hospital 
corpsmen. 

Section  10. — Naval  Instructions  and  Bukeau  Circulars  Relating  to  the 

Bill  Book. 

1381.  Medical  officer  in  command  of  each  hospital  and  the  medical  officer 
of  each  shore  station  shall  keep  a  bill  book.     I  32.58. 

1382.  The  present  hospital  cost  accounting  system  was  devised  to  provide  a 
uniform  sclieme  of  entering  summaries  of  cost  so  that  a  more  accurate  idea 
of  relative  expenditures  in  the  different  departments  could  readily  be  obtained 
and  efficiency  and  economy  of  administration  of  hospitals  be  secured.  In  the 
system  the  following  advantages  accrue: 

(a)  It  provides  a  means  of  accurately  classifying  expenditures,  so  that  sum- 
maries may  be  made  and  analyzed. 

(b)  Continuity  of  practice  is  assured,  even  if  the  personnel  changes. 

(c)  It  provides  an  authoritative  record  of  the  dates  of  completion  of  build- 
ings, their  equipment,  and  current  expenses  of  maintenance  and  operation. 

1383.  The  pharmacist  of  the  hospital,  or  if  there  is  no  pharmacist,  the  chief 
pharmacist's  mate,  shall  be  required  to  familiarize  himself  with  the  bill  book 
and  with  the  system  of  cost  accounting  in  connection  with  his  duties  as  com- 
missary. 

1384.  The  information  to  be  entered  on  the  "  Statement  of  cost  of  mainte- 
nance "  will  be  obtained  from  the  totals  computed  in  the  bill  book. 

Section  11. — Detailed  Instructions  Relative  to  the  Bill  Book. 

1385.  Enter  number  of  all  requisitions  prepared  on  Forms  1.  B,  Ba,  and  4 
in  column  1,  in  numerical  order,  beginning  a  new  series  with  each  fiscal  year 
as  heretofore.  Stub  requisitions  will  be  given  a  distinct  numerical  series,  the 
numbers  thereof  will  also  be  noted  in  column  1,  but  in  red  ink  to  prevent  dupli- 
cation. Hospital  copies  of  requisitions  will  be  kept  in  a  file  marked  "  Requisi- 
tions "  until  the  last  voucher  under  authority  of  the  respective  requisition  has 
been  prepared. 

1386.  Vouchers  are  numbered,  column  .5,  irrespective  of  requisition  numbers, 
and  are  filed  serially  in  a  separate  file  case  marked  "  Vouchers."  beginning  with 
No.  1  each  fiscal  year.  The  first  vouclier  prepared  under  a  requisition  is  given 
the  proper  consecutive  serial  voucher  file  number.  This  voucher  is  entered  on 
and  occupies  the  line  in  the  bill  book  corresponding  to  the  entry  of  the  requisi- 
tion. Subsequent  vouchers,  if  any,  under  authority  of  the  same  requisition  are 
given  a  distinct  line  in  the  bill  book  entered  separately,  but  receive  the  same 
voucher  file  number  (column  5)  as  the  first  voucher  with  the  addition  of  a 
hyphen  number,  2,  3,  4,  etc.,  in  order  of  their  preparation.  All  vouchers  pre- 
pared under  authority  of  any  one  requisition  will  therefore  be  found  with 
that  requisition  under  one  file  number  in  ilie  "  Voucher  "  file  case,  and  the  sev- 
eral   vouchers    hyphenated   with   subnuinbers   in    accordance   with   precedence. 


88  MANUAL   FOR    THE    MEDICAL   DEPAHTMKNT,    U.    S.    XAVY. 

Probably  tho  most  convenient  way  of  filing  rccinisitions-  ami  vour-hers  will  be 
found  in  tlio  jacketing  system.  File  the  requisition  in  a  jacket — a  blank  en- 
velope of  the  heavier  type — noting  on  the  face  thereof  requisition  number, 
liscal  year,  appropriation,  and  such  other  data  as  may  be  re<iuired  for  ready 
reference,  as  shown  below,  and  as  are  requireil  to  be  placed  thereon  from  time 
to  time.  Keep  the  hospital  copy  of  requisition  in  this  jacket  until  last  voucher 
is  paid,  then  transfer  this  jacket  to  the  voucher  tile,  placing  in  it  all  previous 
vouchers.  In  this  maimer  the  requisition  jackets  of  all  unfinished  requisitions 
will  be  together  and  tho  requisition  jacket  becomes  the  voucher  jacket  after 
tJie  requisition  is  completed.  This  jacket  can  also  be  used  for  the  filing  of  all 
correspondence  relating  to  the  particular  requisition.  In  the  ca.se  of  vouchers 
not  covere<l  by  requisitions  of  our  bureau  or  by  no  requisitions  at  all,  it  is  well 
to  jacket  these  in  the  voucher  file,  placing  on  the  jacket  name  of  payee, 
amount,  etc. 

Samples  of  jackets : 

Requisition  jacket  completed : 

Year  1916.      "  lleq.  65.  Voucher  02. 

Appropriation:  Naval  H.  Fund,  Maint.  S. 
Articles :  Instruments.  X-ray  supplies,  etc. 
Total  number  of  items :  9. 

Item.  Awarded  to. 

1-5.  Wappler  El.  Mfg.  Co.,  173  E.  87  St..  NYC 

8-9.  H.  T.  Dakin,  90  W.  B'way.  NYC 

7.  J(»s.  Heinrichs,  948  B'way,  NYC 

6.  Kny-Scheerer  Corp.,  404  W.  27  St.,  NYC 

Total 70.  45 

Sample  of  voucher  file  jacket : 

Tear  1910.  .July.  Voucher  2. 

Provisions  S.  &  A.  Kequisitions. 

Payee.  V.  Amount. 

Supply   Department 2  380. 13 

Supply    Department 2-2  72.02 

I.    Frank 2-3  358.37 

McDermott   Dairy   Co 2-4  508.13 

Strauss  &  Co 2-5  384.41 

Sulzberger  &  Sons 2-15  12.60 

Shults  Bread  Co 2-7  114.87 

Total  for  the  month 1.S30.  53 

1387.  All  expenditures  made  by  and  on  account  of  the  hospital  should  show 
on  the  bill  book,  and  the  form,  statement,  or  paper  showing  an  expenditure 
chargeable  to  the  hospital  should  be  made  a  voucher,  numbered  serially  as 
indicated,  properly  (Mileicd  on  a  separate  line  in  the  bill  book  and  tiled  in  the 
"Voucher"'  files.  Tims,  hospital  copies  (third)  of  all  requisitions  prepared  on 
Fctrms  B.  Ba.  aixl  4;  vaccine  and  antitoxin  receipts  fi\)m  the  bureau;  stub 
nnpii.sitions  on  tho  supply  ollicer  for  labor  and  material ;  pay  roll  for  civil  em- 
ployees, etc.,  all  become  vouchers  when  completed  or  receipted,  and,  a.s  men- 
tioned above,  they  are  to  be  jiroperly  numbered  with  a  serial  voucher  number, 
enterwl  in  the  bill  book  and  filed.  In  the  case  of  provisions  and  supplies  received 
periodically  and  recurring  vouchers  for  services  of  (he  same  type,  all  vouchers 
subsequent  to  the  first  one  shcuild  be  hyphenated.  This  gives  a  means  of  ready 
and  quick  reference  for  totaling  expenditures  for  certain  groups  of  supplies  and 


V. 

Cost. 

.  62 

40.45 

.  62-3 

8.00 

62-4 

17.  50 

.  62-2 

3.90 

MANUAL   FOR    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.  89 

services,  and  while  frreatly  reducing  the  use  of  correspondence  numbers  and 
code  letters,  as  indicated  in  paragraph  5  of  these  instructions,  furnishes  but 
another  quick  method  which  is  useful  for  reference  purposes.  This  metliod  of 
entry  will  reduce  greatly  the  number  of  voucher  nunibers.  condense  and 
simplify  the  voucher  file.  Since  provision  vouchers  are  now  paid  monthly  they 
would  mount  into  hundreds  of  voucher  numbers  if  given  individual  number's 
for  each  public  bill.  All  vaccines,  for  instance,  obtained  by  letter  or  tele- 
gram from  the  bureau  should  be  entered  in  this  way.  The  same  should  be 
done  in  the  case  of  stubs,  but  with  the  following  modification.  All  work  done 
by  the  navy  yard  on  job  orders  is  now  stubbed  out.  It  is  well,  therefore,  to 
divide  the  stubs  into  two  classes,  those  covering  job  orders  and  those  issued 
to  cover  deliveries  of  material.  In  this  manner  all  stubs  for  material  will  have 
one  voucher  number  and  all  stubs  covering  j()l>  orders  will  have  another  voucher 
number,  thus  allowing  a  quick  compilation  of  the  cost  of  material  on  one  hand 
and  the  cost  of  work  performed  on  the  other.  At  the  end  of  the  fiscal  year  a 
complete  history  of  expenses  incurred  by  and  on  account  of  the  hosi)ital  will 
be  obtained  in  one  numerical  file,  and  this  voucher  file,  in  conjunction  with 
the  bill  book,  will  offer  ready  moans  of  reference  as  to  any  financial  transac- 
tion during  the  fiscal  year  involved ;  they  should  be  regarded  as  the  permanent 
record  for  all  financial  transactions  pertaining  to  the  hospital,  and  be  carefully 
preserved. 

13S8.  All  expenditures  other  than  those  falling  under  colunm  15  are  entered 
twice  on  the  bill  book — first,  under  the  proper  appropriation  heading,  colunms 
10  to  14,  inclusive ;  and,  second,  the  same  amount,  split  up  if  required,  is 
entered  under  the  respective  group,  or  groups,  under  the  heading  "Analysis  of 
expenditures."  It  is  therefore  evident  that  the  totals  under  colunms  10,  11, 
12,  13,  and  14  should  at  all  times  balance  those  under  columns  IG  to  44,  in- 
clusive. Column  15  shows  expenditures  made  by  and  on -account  of  the 
hospital,  but  where  the  expense  is  chargeable  to  some  appropriation  not  under 
the  cognizance  of  the  Bureau  of  Medicine  and  Surgery.  Enter  figures  under 
this  column  in  red  ink  and  exclude  same  from  all  totals. 

1389.  Column  8  is  to  be  used  for  entering  the  corre.spondence  file  number 
whenever  the  requisition  or  voucher,  or  the  subject  matter  thereof,  has  been 
given  a  correspondence  number.  This  colunm  is  also  intended  to  be  used  as  a 
means  of  rapidly  segregating  and  totaling  a  series  of  vouchers  pertaining  to 
one  contract;  material  purchased  in  the  erection  of  some  particular  structure; 
or  in  any  case  where  it  becomes  necessary  to  secure  a  total  from  sevei-ai 
vouchers  which  otherwise  would  not  be  quickly  obtainaI)le.  The  items  may 
have  been  purchased  at  different  times,  under  separate  requisitions,  or  from 
several  firms ;  again,  it  might  be  desirable  to  know  exactly  the  amount  or  cost 
of  some  article  repeatedly  received  on  stub  requisition,  e.  g.,  lumber  to  be 
used  in  building.  By  giving  such  vouchers,  when  filed,  the  .same  code  letter 
they  can  at  any  time  be  readily  segregated  and  totaled  by  running  down  columu 
8  iUKl  selecting  those  bearing  a  similar  letter.  Use  capital  letters  of  the  alpha- 
bet in  this  connection. 

1390.  All  stores,  except  stationery,  received  from  the  supply  depots  on  Forms 
B,  B:i.  and  4  should  be  charged  under  the  appropriation  "Medical  Department, 
U.  S.  Navy,"  column  11.  Books  and  stationery  should  be  charged  against  the 
appropriation  "  Contingent.  M.  &  S."  colunm  12.  Towels,  l)edding,  etc.,  re- 
ceived from  the  supply  depot  under  the  special  annual  requisition  form,  are  a 
charge  against  the  naval  hospital  fund,  column  10.  In  posting  the  several 
classes  here  referred  to  under  the  "Analysis  of  expenditures  "  care  should  be 
exercised  to  see  that  they  are  entered  under  the  proper  heading  or  headings. 
Bedding  has  a  distinct  column ;  so  with  books  and  stationery ;  all  mess  gear ; 
chinaware.  etc..  should  be  entered  under  "Culinary  department." 

1391.  Since  Form  Y,  for  the  preparation  of  which  "  Medical  supplies  "  columns 
19  and  20  were  spearated,  has  been  abolished,  the  following  change  as  shown 
below  has  been  made  in  the  bill  book.  The  entries  under  tlie  rearranged 
columns  are  self-ex;ilanatory. 

Changes  under  columns  19  to  23  in  bill  book: 


90 


MANUAL    FOR    THE   MEDICAL   DEPARTMENT,  V.   S.    NAVY. 


Hospital  supplies. 

Ambulance  service. 

Medicines,    disin- 
fectants,     tab- 
lets,   surgical 
dressings,       dis- 
pensary and  lab- 
oratory     equip- 
ment, etc. 

Sargical      instrii- 

Hospital       appli- 
ances, ward  and 
sick  room  oqiiip- 
meut,  disinfect- 
ing   apparatus, 
tents,  etc. 

Live  stock,  wag- 
ons,    ambu- 
lances, harness, 
etc. 

Provender,  pasfv 
line,  horseshoe- 
ing, tires,    re- 
pairs, etc. 

pliances,  X  ray. 
operating,    and 
hydrot  hora- 
peutic     room 
equipment,  etc. 

19 

20 

21 

22 

23 

"Hospital  supplies,"  columns  19,  20,  and  21,  include  medicines,  ho-spital 
stores,  surgical  in.struments  and  appliances  (except  artificial  limbs),  surgical 
dressings,  dispensary  furniture  and  accessories,  hospital  furniture.  (Furni- 
ture and  furni.shings  for  the  hospitals  not  strictly  included  under  hospital  fur 
niture  are  entered  under  column  34;  furniture  and  furnishings  for  stafC  and 
other  quarters  under  column  17.) 

1392.  Vaccine,  serum,  etc.,  received  from  the  Bureau  of  Medicine  and 
Surgery  are  a  charge  against  the  appropriation  "Medical  Department,  U.  S. 
Navv,"  column  11. 

139S.  Microscopical  outfits  and  any  supplies  received  from  the  Naval  Med- 
ical School  are  a  charge  against  the  appropriation  "Contingent,  M.  &  S.," 
column  12. 

1394.  Enter  coal  and  wood  used  in  kitchen  imder  column  26. 

1395.  Under  "Miscellaneous,"  column  25,  enter  ice,  artificial  limbs,  athletic 
goods,  typewriters,  subscriptions,  cleaning  gear,  brooms,  matches,  electric  bulbs, 
maintenance  of  patients  at  other  hospitals,  and  such  other  charges  as  can  not 
be  directly  placed  against  any  one  department  of  the  hospital. 

1396.  Vouchers  prepared  under  one  contract  pertaining  to  buildings  and 
construction,  entered  under  column  16,  should  continue  to  receive  the  same 
serial  voucher  file  number  as  of  the  fiscal  year  in  which  the  first  voucher  was 
prepared,  even  though  operations  are  carried  beyond  the  end  of  the  fiscal  year. 
This  will  confine  them,  and  make  the  cost  appear  as  a  whole  under  one  entry 
in  the  "  recapitulation  "  when  the  work  has  been  completed. 

1397.  At  the  completion  of  each  fiscal  .vear  the  totals  of  the  several  columns 
will  be  computed  and  entered.  The  record  and  transaction  for  the  year  will 
then  be  recapitulated  on  a  separate  page  in  the  bill  book,  this  page  to  be  the 
final  one  for  the  year  in  question,  tlie  recapitulation  to  be  made  according  to: 
(1)  Appropriations;  (2)  the  several  departments  of  the  hospital;  (3)  land, 
huildlngs,  permanent  constniction,  etc.;  (4)  civil  establishment;  (5)  hospital 
maintenance;  thus: 

Recapitnlatinn  flftcal  year  1915. 


Appropriation:  )  .^  ;( 

Kavnl  hospital  fund 

Medical  nopartmont,  U.  S.  N. 

Contingent.  M.  &  S 

Brinfjing  homo  remains,  etc.. 

Specific  apjiroprialion 

Medicnl  supplies 

Ambulance  service 

Power  house 

Culinaiy  department 

lyaitndrV. 


•i^il  fti  i;;iiULi 


Cohimn.    !  Amount. 


Provisions 

Laundry  building. 

Mortuary 

Sidcwnlk'j 


10 

11 

12 

13 

14 

10.2^.21 

22. 23, 31'. 

24,26,37 

2';,  38 

27,39 

28 


LanI,  htiii  lings,  permanent  construction,  etc.,  column  10(to  be  shown  in  detail). 

Ci  *  il  estal  il  isl  line  ri  I : 

Hospital  mii'if.  1.  incr 


3.-41 
10  35 


$15,000 

5,ono 

3,5tK) 
360 
5,000 
6,000 
1,500 

13,000 
6,000 
l,(it)0 

20,000 
5,000 
2,.*)O0 
1,200 

8,0«1) 
75,000 


MANUAL   FOB   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.  91 

Section   12. — Detailed   Instructions  Relating  to  the  Commissaey  Ledger. 

1411.  The  systoui  of  keepin.^  accounts  in  the  commissary  department  of  the 
hospitals  is  essentially  one  of  daily  balance  of  receipts  and  expenditures,  both 
as  to  quantities  of  stores  and  the  cash  values  thereof,  with  a  summary  of  the 
whole  at  the  end  of  each  month.  This  gives  an  accurate  knowledge  of  com- 
missary stores  on  hand  at  all  times  as  well  as  their  value,  shows  the  expendi- 
tures of  any  item  at  a  glance,  and  with  the  ration  memoranda  affords  a  ready 
means  of  computing  the  average  per  diem  cost  of  subsistence.    . 

1412.  Receipts  and  expenditure  voucher  contains  the  transaction  of  com- 
missary stores  received  and  expended  and  the  cash  value  thereof  for  one  day. 
The  entries  hereon  are  taken  from  dealers'  bills  and  supply  officer's  invoices 
and  from  the  rough  memoranda  of  stores  issued  (on  hand)  from  the  storeroom. 
Stores  on  delivery  should  be  accompanied  by  duplicate  invoices,  and  these 
should  be  initialed  by  the  officer  responsible  for  the  proi>er  inspection  and 
weighing  of  the  stores.  One  invoice  is  returned  to  the  dealer,  the  other  kept 
on  file  in  the  hospital  and  used,  as  before  stated,  in  preparing  the  daily  receipt 
and  expenditure  voucher.  The  completed  receipt  and  expenditure  voucher  for 
the  day  is  submitted  on  the  following  morning,  throufih  the  executive  officer  to 
the  commanding  officer  of  the  hospital,  and  upon  its  return  a  transcript  of  the 
entries  thereon  is  made  in  the  commissary  ledger,  the  quantities  received  and 
expended  under  the  respective  headings  and  the  cash  value  of  the  day's  receipts 
and  expenditures  in  the  appropriate  columns  to  the  extreme  right  on  the  last 
page  for  the  month  concerned.  The  commissary  ledger  is  a  loose-leaf  system 
ledger  with  two  distinct  kinds  of  pages,  those  containing  the  "  Cash  values  " 
columns  being  supplied  in  more  limited  quantity,  only  one  of  these  pages  being 
used  each  month,  the  last  for  the  month  concerned.  The  cash  extensions  for 
each  day's  transactions  are  here  entered.  A  study  of  these  pages  makes-  their 
use  plain.  It  will  be  noted  in  the  commissary  ledger  that  each  item  contains  sepa- 
rate columns  for  the  entry  of  receipts  and  expenditures — marked  "  R  "  and  "  E," 
respectively.  To  distinguish  more  clearly  between  the  two.  receipts  are  en- 
tered with  black  ink,  expenditures  with  red  ink.  To  prepare  the  commissary 
ledger  for  entries  write  the  name  of  the  different  articles  purchased  and  on 
hand  under  the  column  "  Items."  Enter  unit  and  unit  price  in  the  two  columns 
below  the  item  name. 

1413.  On  the  last  day  of  each  month  take  an  inventory  and  enter  the 
amounts  on  hand  under  "  Brought  forward  "  for  the  succeeding  month,  calcu- 
lating their  value  always  by  the  last  contract  price.  Fill  in  at  the  end  of  each 
month  columns  on  the  bottom  of  the  pages.  Enter  under  "Carried  over  from 
last  month "  stores  remaining  from  previous  month.  The  amounts  on  line 
•'  Received  this  month,"  obtained  by  deducting  the  "  Carried  over  from  last 
month  "  column  from  the  totals,  has  to  correspond  with  the  totals  of  dealers' 
or  supply  officer's  bills.  Under  column  "  Unexpended  "  will  appear  the  differ- 
ence between  the  receipt  and  expenditure  columns,  and  under  column  "  Inven- 
tory "  the  actual  amount  on  hand  as  found  by  the  inventory.  The  difference 
between  these  two  columns  gives  the  "Loss  on  issue."  The  money  value  of 
the  "Loss  on  issue"  column  plus  "Total  expenditures"  gives  the  "Total  cost 
of  subsistence.  Since  provision  vouchers  are  now  paid  monthly  by  the  ho.s- 
pitals.  the  following  easy  method  of  proving  the  correctness  of  the  totals  in  the 
"  Cash  values  "  column  should  be  employed :  To  the  sum  total  of  vouchers  for 
stores  obtained  during  the  month  add  the  value  of  the  stores  brought  forward 
from  the  previous  month ;  this  represents  the  absolutely  correct  value  of  re- 
ceipts. If  the  sum  so  obtained  differs  from  the  sura  total  of  the  daily  receipts, 
as  it  is  bound  to  do,  due  to  fractional  differences  and  possible  clerical  en*ors, 
write  under  the  total  "  Corrected  totals  "  and  the  sum  found  in  that  way  in  red 
Ink.  By  deducting  the  value  of  stores  found  on  hand  by  inventory  from  the 
above  siim  the  absolutely  correct  total  for  expenditures  will  be  found,  and  the 


92  MANUAL    FOR    THE    MEDICAL    DEPARTMENT,   U.    S.    NAVY. 

same,  if  differinji  from  tlie  totals  obtained  from  the  totals  of  the  daily  entries, 
sliould  be  entered  in  the  same  waj'  as  "  Corrected  total."  By  dividing  the 
corrected  total  of  exiienditures  by  the  total  number  of  rations,  obtained  from 
ration  memoranda,  the  "Average  cost  of  subsistence  per  diem  "  is  obtained. 
Only  provision  Koms  are  to  be  carried  in  the  commissary  ledger. 

1415.  Tlu'  ration  return  will  be  lillcd  in  from  day  to  day  according  to  the 
changes  resulting  from  admission  and  discharge  of  patients,  transfer  of  hos- 
pital corpsmen,  employment  and  discharge  of  civilian  employee.s,  etc.  The  sura 
total  of  colums  1  to  9.  inclusive,  less  .sum  total  of  colunms  10  to  14.  inclusive, 
will  give  the  actual  lunuber  of  rations  issued.  To  tlnd  the  average  cost  of  sub- 
sistence for  any  given  time  divide  the  total  of  expenditures  taken  fnnn  the 
connnissary  ledger  by  the  sum  total  of  rations  issued  during  the  corresponding 
time. 

1416.  Consideration  should  he  given  to  the  question  of  reducing  the  number 
of  open  purchase  requisitions  from  hospitals.  As  the  now  bill  book  provides 
for  the  necessary  classification  of  purchases  into  the  several  hospital  depart- 
ments under  "Analysis  of  Expenditures."  no  reason  remains  for  limiting  requi- 
sitions in  this  respect.  The  only  consideration  in  preparing  open-purchase 
requisitions  for  the  purchase  of  supplies,  etc.,  is  the  question  of  the  appropri- 
ation involved,  as  it  is  prescribed  (Art.  I  4654  (2).  N.  R.  1913),  that:  "They 
must  embrace  only  articles  required  under  one  appropriation." 

1417.  Commanding  officers  of  hospitals  will  see  that  persons  charged  with 
the  duty  of  preparing  requisitions  are  thoroughly  familiar  with  the  section  of 
the  instructions,  article  4C.j1.  et  seq.,  pertaining  to  the  open  purchase  of 
supplies. 

1418.  To  assist  the  purchasing  pay  officer  in  preparing  proposals  to  secure 
bids  from  several  dealers  it  is  well  to  have  the  items  of  a  similar  nature  on  a 
requisition,  or  those  any  one  dealer  would  probably  bid  on  follow  in  sequence 
on  tlie  face  of  the  requisition. 

Section  13. — Instructions  Reg.\rding  the  Preparation  of  the  Statement  of 

Cost  of  Maintenance. 

1421.  Under  item  No.  K)  enumerate  in  detail  all  permanent  construction  on 
which  work  was  commenced  during  the  fiscal  year,  whether  completed  or  not. 
If  work  has  not  been  completed  insert  "Not  complete"  in  place  of  cost;  the 
date  of  completion,  with  cost,  to  be  shown  on  statement  of  succeeding  year,  e.  g. : 

Laundry  building,  1911,  completed  3-1-1912 ; .$5,000 

1422.  The  total  number  of  .subsistence  days  (item  No.  11)  is  obtained  "l)y 
combining  the  32  monthly  totals  taken  from  tlie  i-ation  .memoranda  for  tl»c 
fiscal  year  concerned. 

1423.  The  average  cost  per  diem  of  maintenance  (item  No.  12)  will  bo  deter- 
mined by  <livifling  "Hospital  maintenance"  (item  No.  1)  by  "Total  number  of 
subsistence  days"   (item  No.  11). 

1424.  The  average  cost  per  diem  for  subsistence  (item  No.  13)  will  be  deter- 
mined by  dividing  total  cost  of  "Provisions"  (item  No.  2)  and  cost  of  stores 
carried  over  from  hist  month  of  preceding  fiscal  year,  but  less  amount  of  stores 
on  hand  as  shown  by  inventory  on  .Tune  30  of  the  year  in  coinmi.ssary  ledger, 
by  "Total  number  of  subsistence  days  "  (item  No.  11). 

1425.  Example: 

Stiukct:  Statement  of  Co.st  of  Maintenance,  Fiscai.  Yi.ak  191 — . 
Expcnditurpn:  TaUrn  from  hospital  bill  hnol:. 

1.  Hospital  maintenance,  bill  book,  columns  19  to  35,  Incbisive "^ 

2.  Provisions,  bill  book,  colmim  2S 

3.  Medical  supplies,  bill  book,  colunuis  19  and  20 


MANUAL    FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.  93 

Ex  pen  (lit  arcs:  Taken  frotn  hospital  hill  hook — Continued. 

4.  Ambulance  service,  bill  book,  columns  21,  22.  23,  and  3" 

5.  Power  house,  bill  book,  columns  24,  25,  and  37 

6.  Culinary  department,  bill  book,  columns  26  and  38 

7.  Laundry,  bill  book,  columns  27  and  39 

8.  Care  of  jj:rounds.  buildings,  bill  book,  columns  32  and  40 

9.  Civil  establishment,  bill  book,  colunms  36  to  41,  inclusive 

10.  Land,  buildings,  permanent  construction,  etc.,  bill  book,  column  16 

to  be  shown  in  detail,  with  date  of  completion,  as  per  recapitu- 
lation in  bill  book,  as  follows : 

11.  Total  number  of  subsistence  days  for  fiscal  year 

12.  Average  cost  per  diem  of  maintenance ^ 

13.  Average  cost  per  diem  of  subsistence 

In  duplicate. 

1426.  Under  urgent  deficiency  act,  June  15.  1917.  it  is  directed  that  groceries, 
meats,  ice.  milk,  etc.,  obtained  under  general  Navy  contracts  made  by  the 
Bureau  of  Supplies  and  Accounts  be  paid  from  the  appropriation  "  Hospital 
expenses."  The  title  entered  on  public  bills  will  be:  "8804,  Hospital  e.\penses, 
191':--1918." 

Section  14. — Duties  of  the  Master  at  Arms  and  the  Chief  Pharmacist's 

Mate  of  the  Day. 

1431.  The  master  at  arms  shall  have  supervision  over  Hospital  Corps  quar- 
ters, brigs  and  bagrooms  and  also  over  the  morgue  and  the  cleaning  detail 
(outside  of  Avards)  under  such  regulations  as  may  be  established  by  the  execu- 
tive surgeon. 

1432.  When  the  mai?ter  at  arms'  duty  for  the  day  is  completed  (4.30  p.  m. 
on  his  liberty  days),  the  chief  pharmacist's  mate  of  the  day  becomes  the  acting 
master  at  arms.  He  shall  receive  the  9  p.  m.  reports  from  wards,  see  that  the 
lights  are  out  and  the  hospital  is  secure,  and  make  report  to  the  officer  of  the 
day,  and  perform  all  other  duties  of  the  master  at  arms  until  relieved  by  the 
master  at  arms  in  the  morning. 

1433.  The  master  at  arms  shall  see  that  the  bagroom  is  open  on  the  days 
and  hours  designated  in  the  hospital  routine.  He  sliall  not  permit  any  member 
of  the  Hosjiital  Corps  to  enter  the  bagroom,  except  when  stowing  baggage,  or 
\yhen  inspecting  the  baggage  of  patients  about  to  be  discharged,  which"  inspec- 
tion in  all  cases  M-ill  be  done  under  the  personal  supervision  of  the  master  at 
arms.     Patients  shall  not  be  allov.-ed  to  enter  the  bagroom  at  any  time. 

1434.  The  master  at  arms  sliall  receive  from  the  night  Hospital  Corpsman 
at  7  a.  m.  daily  reports  of  those  absent  without  leave  or  overtime,  and  at  a 
designated  hour  he  shall  report  upon  the  same  and  also  upon  the  condition  of 
prisoners  and  any  other  matters  of  interest.  He  shall  furnish  the  officer  of 
the  day  with  the  names  of  those  absent  without  leave,  and  of  all  prisoners  to 
be  released  or  confined,  for  entry  in  the  daily  journal. 

1435.  Chief  pharmacist's  mates  shall  become  chief  pharmacist's  mates  of  the 
day  in  rotation  after  4.30  p.  m.,  when  they  shall  perform  the  duties  of  those  chief 
pharmacist's  mates  who- are  absent,  on  leave,  or  off  duty. 

Section  15. — Duties  of  Chief  Nukses  and  Nurses  in  Hospitals. 

1441.  The  authority  of  a  nurse,  necessary  for  the  performance  of  duty  to 
which  she  may  be  assigned,  shall  be  duly  recognized  and  enforced.  '  (R 
3322  (5).) 

1442.  Nurses  shall  familiarize  themselves  with  the  Navy  Regulations,  Naval 
Instructions.  Manual  for  the  Medical  Department,  and  General  Orders,  in  so 
far  as  they  relate  to  the  Nurse  Corps. 


94  MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

1443.  (a)  The  position  of  tlie  diief  nurse,  so  far  as  naval  conditions  permit, 
is  equivalent  to  that  of  a  superintendent  of  nurses  in  a  civilian  hospital.  She 
shall  have  general  sni)ervision  of  all  the  nursing  service  and  shall  instruct  the 
nurses  in  duties  pecrliar  to  naval  work.  She  .shall  firmly  and  faithfully  exe- 
cute the  orders  of  the  executive  surgeon  and  shall  keep  herself  informed  of  his 
wishes  in  matters  of  duty  and  shall  carry  them  out  scrupulously  and  enei- 
getically. 

{b)  She  shall  confer  with  the  executive  surgeon  regarding  details  of  duty  t<> 
which  nurses  are  assigned,  arrange  their  working  schedule,  and  be  responsible 
for  the  execution  of  orders. 

(c)  Slie  is  responsible  for  the  maintenance  of  order  among  the  nurses  and 
shall  correct  abuses  and  prevent  violation  of  discipline,  reporting  to  the  execu- 
tive surgeon  any  infractions  of  discipline.  In  the  case  of  neglect  of  duty,  breach 
of  discipline,  or  failure  to  obey  orders  from  proper  authority,  the  chief  nurse 
may  temporarily  relieve  the  nurse  from  duty,  and  she  shall  report  the  case  at 
once  to  the  executive  surgeon  and  medical  officer  in  command. 

(d)  In  arranging  the  detail  of  nurses  for  night  duty,  the  chief  nurse  will 
be  careful  to  see  that  this  duty  is  distributed  equally  among  the  members  of 
the  nursing  staff. 

e)  The  chief  nurse  shall  be  directed  to  hold  a  nurses'  conference  once  a 
week  at  a  stated  period  approved  by  the  conunanding  officer,  to  be  attended  by 
all  the  nur.ses  on  duty  at  the  station,  for  the  purposes  of  instructisn  and  of  dis- 
cussing such  nursing  problems  as  may  have  arisen. 

(/)  The  chief  nur.se  shall  always  accompany  the  conunanding  officer  during 
the  weekly  inspection  of  the  hospital,  and  she  shall  make  an  inspection  at  least 
twice  a  day  of  those  parts  of  the  hospital  where  nurses  are  in  charge  or  on  duty. 

1444.  Official  reports  and  requests  submitted  by  nm'ses  shall  be  forwarded 
through  the  chief  nurse  and  the  executive  surgeon  for  submission  to  the  com- 
manding officer. 

General  instructions  relative  to  the  duties  of  nurses  shall  be  transmitted 
through  the  chief  nurse. 

1445.  (a)  The  chief  nurse  shall  have  charge  of  the  sick  records  and  health 
records  of  nur.ses  and  of  records  and  inventories  relating  to  Government  prop- 
erty in  the  nurses'  quarters,  and  exercise  general  supervision  over  nurses' 
quarters,  linen  rooms,  and  diet  kitchens. 

(ft)  It  shall  be  the  duty  of  the  chief  nurse  to  keep  the  official  register  of 
nurses,  in  which  she  shall  enter  the  name,  date  of  reporting,  days  sick  or  on 
leave,  efficiency  marks,  name  and  address,  or  any  other  facts  concerning  each 
nurse  that  may  be  important  to  record,  and  such  register  shall  be  under  her 
charge  and  available  for  inspection  by  the  commanding  officer  or  executive 
surgeon  whenever  called  for. 

(c)  The  chief  nurse  shall  also  keep  a  daybook,  in  which  the  detail  of  nurses 
to  duty  for  the  day  is  entered,  the  nature  of  the  duty,  number  of  hours  on  duty, 
etc.,  of  each  nurse. 

144G,  It  shall  be  the  duty  of  the  chief  nurse  to  report  immediately  to  the 
executive  surgeon  any  sickness  requiring  the  relief  of  a  nurse  from  duty,  unless 
the  illness  is  of  a  conlidential  nature,  in  which  case  she  .shall  make  a  confidential 
report  tp  the  comniaiiding  officer.     (See  chap.  5.  sec.  9.) 

1447.  When  required,  the  chief  nurse  shall  supervise  the  instruction  of 
Hospital  Corpsmen  In  their  nursing  duties. 

1448.  When  a  chief  nurse  is  granted  leave,  or  is  otherwise  absent  fron\  duty, 
her  duties  will  be  assumed  by  the  senior  nurse  recommended  for  promotion,  or 
If  none  has  been  so  recommended,  by  the  nurse  best  qualified,  having  regard  to 
seniority  as  well  as  ability. 

1449.  Nurses  will  be  under  the  immediate  supervision  of  the  chief  nurse  and 
directly  responsible  to  her  in  matters  relating  to  duty,  conduct,  anrl  discipline. 

1450.  Nurses  In  charge  of  wards,  openiting  rooms.  Iin(<n  rooms,  or  diet 
kitchens,  permanently  or  for  the  time  being,  shall,  for  purposes  of  direct  care  of 
the  sick,  order  and  cleanliness,  have  direction  and  control  over  Hospital  Oorps- 


MANUAL   FOR   THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY.  95 

men  assigned  to  duty  with  them,  and  shall  be  responsible  for  their  conduct 
attention  to,  and  practical  instruction  in  their  duties.  In  case  of  inattention 
or  of  neglect  of  duty  or  of  insubordinate  conduct  on  the  part  of  Hospital  Corps- 
men  under  her  control,  the  ward  nurse  shal  report  the  matter  to  the  chief  nurse 
and  the  ward  officer,  or,  in  his  absence,  to  the  officer  of  the  day,  (See  R  3322 
(5)  and  I  3228.) 

1451.  Under  proper  restrictions  and  on  suitable  occasions,  nurses  shall  have 
the  undisputed  right  to  communicate  with  the  commanding  officer  of  the  hos- 
pital. Such  applications  shall  be  made  through  the  chief  nurse  and  executive 
surgeon,  who  will  first  investigate  the  complaint  or  request  and  be  able  to 
express  their  approval  or  disapproval  of  the  same.  A  nurse  will  be  held  ac- 
countable for  vexatious,  frivolous,  or  false  complaints. 

1452.  Nurses  will  be  required  to  keep  such  hours  on  duty  as  may  be  decided 
upon  by  the  chief  nurse  after  consultation  with  the  executive  surgeon,  but  ordi- 
narily the  unit  of  a  hospital  day's  duty  will  be  considered  to  be  eight  hours, 
either  cons>.^cutively  or  in  such  broken  periods  as  will  best  suit  the  requirements 
of  the  hospital  service. 

1453.  Nurses  will  not  be  detailed  for  general  duty  in  venereal  wards,  and  a 
nurse  will  not  be  required  to  care  for  a  patient  continuously  for  a  longer  period 
than  12  hours  at  one  time,  except  in  special  instances.     " 

1454.  No  nurse  will  be  required  to  take  night  duty  for  more  than  a  month 
consecutively,  unless  in  some  special  exigency  of  the  service,  and  no  nurse  will 
ordinarily  be  called  upon  for  night  duty  more  frequently  than  one  month  out  of 
every  three. 

1455.  In  hospitals  where  there  is  an  active  operating  service  a  nurse  detailed 
to  an  operating  room  may  be  exempted  from  night  duty  on  the  recommendation 
of  the  chief  nurse,  if  such  exemption  is  approved  by  the  commanding  officer.  A 
similar  rule  may  be  applied  to  the  nurse  assigned  as  a  diet  nurse,  and  to  the 
nurse  assigned  to  duty  in  charge  of  the  linen  room,  if  considered  desirable  by 
the  commanding  officer.  These  exemptions  from  night  duty  of  the  operating 
room,  linen  room,  and  diet  nurses  may  be  applied  only  in  the  larger  hospitals. 
Nurses  will  not  ordinarily  serve  continuously  for  a  longer  period  than  six 
months  in  the  operating  room,  or  on  other  special  details.  Exceptional  cases 
will  be  promptly  reported  to  the  Surgeon  General. 

1456.  The  ward  nurse'  shall  be  in  full  authority  as  such,  and  will  be  held 
responsible  for  the  keeping  of  the  records,  cleanliness,  order,  and  general  man- 
agement of  the  ward.  It  shall  be  part  of  her  duties  to  instruct  Hospital  Corps- 
men  in  all  matters  pertaining  to  the  care  of  the  sick,  such  as  the  administra- 
tion of  medicines,  giving  baths,  taking  of  temperatures,  pulse,  and  respiration 
rates,  etc.  The  nurses  will  advise  the  chief  nurse  concerning  the  efficiency  and 
progi-ess  of  the  Hospital  Corpsmen,  and  the  chief  nurse  will  submit  these  reports 
to  the  executive  officer. 

1458.  A  ward  nurse  shall  not  be  called  away  from  her  station  and  duty 
except  for  urgent  reasons;  nor  shall  she  absent  herself  from  her  post  of  duty 
without  being  properly  relieved. 

1459.  The  nurse  on  duty  or  the  chief  nurse  shall  always,  unless  excused, 
accompany  any  officer  officially  visiting  that  part  of  the  hospital  under  her 
charge. 

1460.  The  ward  nurse  shall  require  all  patients  (not  excused  by  proper 
authority)  to  be  present  at  sick  call,  morning  and  evening,  and  will  report  the 
names  of  those  absent  without  leave  or  over  leave  to  the  officer  holding  the  sick 
call. 

1461.  Ward  nurses  are  responsible  for  the  condition  of  bed  patients  as  to 
cleanliness,  clinical  data,  etc.  They  shall  make  careful  bedside  notes  of  all 
cases  unless  otherwise  ordered  by  the  ward  officer. 

1462.  Nurses  are  responsible  for  all  keys  under  their  charge.  When  leaving 
the  ward  such  keys  must  be  transferred  to  the  senior  Hospital  Corpsman  in 

>  The  term  "  ward  nurse  "  Is  used  throughout  In  the  sense  of  "  nurse  in  charge  of  ward." 


96  MANUAL   FOR    THE    MEDICAL    DEPARTMENT,   U.    S.    NAVY. 

the  ward,  who  will  be  held  responsible  for  them,  and  maintain  discipline  during 
her  absence. 

1463.  (ff)  Xursos  shall  bo  responsible  for  the  administration  of  medicines 
and  shall  report  any  patient  who  refuses  or  fails  to  take  his  medicine  at  the 
appointed  time.  Nurses  shall  see  that  all  poisons,  narcotics,  and  liquors  are 
kept  under  lock  and  key. 

(b)  Nurses  shall  be  especially  careful  with  regard  to  poisons,  and  shall  see 
that  the  instructions  concerning  the  care  of  poisons  and  the  use  of  poison  con- 
tainers are  faithfully  enforced. 

1464.  Nurses  shall  see  that  money  and  valuables  of  patients  who  so  request 
are  transferred  to  the  ward  oflicer  for  safe-keeping.  This  shall  always  be  done 
in  cases  wliere  the  patient's  condition  is  .such  as  to  render  him  unfit  to  safe- 
guard his  posse.ssions. 

1465.  The  ward  nurse  shall  make  the  detail  of  duty  for  Hospital  Corps  men 
assigned  to  the  ward,  designating  to  each  the  duties  he  shall  perform  from  the 
time  of  reporting  to  tlie  time  he  is  relieved.  Nurses  in  charge  of  property  shall 
report  in  writing  to  the  executive  surgeon  breakage  of  articles  on  charge  and 
fix  the  responsibility  for  such  breakage,  if  possible. 

1466.  The  ward  nurse  shall  be  notified  when  a  patient  is  to  be  confined  in 
the  brig  or  is  to  be  restricted  to  the  ward  or  hospital.  AVhen  a  patient  is  con- 
fined in  the  brig  or  is  absent  without  leave  for  over  24  hours,  she  shall  have  all 
his  clothing  and  belongings  collected,  make  a  list  of  .same,  and  turn  list  and 
property  over  to  the  master  at  arms.  "When  a  patient  leaves  the  hospital  she 
shall  .see  that  he  turns  in  all  ward  linen  and  wearing  apparel  Issued  to  him. 

1467.  The  ward  nurse  will  be  responsible  for  the  proper  keeping  of  the  fol- 
lowing books  and  forms  or  any  other.s  that  may  be  autliorized  from  time  to 
time: 

(a)  Property  accountability  cards:  Tliese  cards  shall  be  used  in  making 
requisitions  for  unexpendable  articles  and  for  turning  the  .same  jn  for  survey 
or  to  store.  These  are  to  be  signed  by  the  ward  oflicer  and  countersigned  by  the 
executive  surgeon. 

(h)  Ward  property  book:  Shall  contain  record  of  all  property  on  charge  and 
show  all  changes  entailed  by  receipt  of  fresh  supplies  and  surveys.  The  prop- 
erty book  will  be  verified  by  a  monthly  inventory,  or  oftener  if  deemed  neces- 
sary. 'I, 

(c)  Admi.ssion  reports:  Shall  show  full  name,  rank  or  rate,  religion,  and  tliie 
day  and  hour  of  admission  of  patient ;  also  the  nanie  and  postal  and  telegraphic 
address  of  the  next  of  kin. 

{d)  Discharge  reports:  Shall  show  name,  rank  or  rate,  and  the  day  and  hour 
of  discharge  of  patient,  and  the  address  to  which  mail  shall  be  forwardcil. 

Reports  {(■)  and  ((0  to  be  sent  to  the  ward  officer  as  soon  as  practicable. 

(e)  Clinical  notes. 

(/)  Daily  report  of  patients:  Shall  show  the  number  of  patients  received, 
discharged,  etc.,  number  of  vacant  beds  in  ward,  and  names  and  rates  of  pa- 
tients recommended  by  the  ward  officer  for  discharge  or  survey.  These  reports 
are  to  be  sent  to  the  executive  surgeon  immediately  after  sick  call. 

((/)  Liberty  list:  Shall  conlain  the  names  of  patients  and  Hospital  Corps- 
men  recommended  for  lil)erty  i)y  the  ward  officer. 

(/i)  Liglit-duty  list:  Shall  be  pf)sted  daily,  showing  names  of  patients  de- 
tailed fur  light  duty  in  the  ward,  with  Ihc  specific  duty  each  is  to  vierform. 
The  ward  uur.se  will  also  revise  daily  the  list  of  patients  for  duty  outside  the 
ward. 

(t)  Ward  order  book:  All  orders  relative  to  the  treatment  of  patients  shall, 
so  far  as  i)racticable,  be  legil)ily  and  explicitly  entered  in  this  book  and  signed 
by  the  medical  oMieer. 

146S.  Tile  night  nur.se  shall  be  informed  of  all  emergencies  arising  in  the 
wards  and  is  responsible  for  giving  timely  information  to  the  offictM*  of  the  day. 
.Ml  onh-rs  relative  to  treatnuiit  shall  be  giviMi  to  lier  and  she  will  be  responsible 
for  carrying  them  out.     r.efore  going  off  duty  she  shall  see  tliat   tli(>  morning 


MAN^UAL   FOE   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.  97 

routine  is  being  carried  out  and  leave  a  written  report  of  any  incident  worthy 
of  note  occurring  during  the  watch. 

1469.  A  nurse  shall  be  detailed  for  duty  in  the  operating  room  and  will  be 
responsible  for  its  upkeep  and  cleanliness  and  for  the  general  surgical  technique 
therein. 

1470.  Example  of  a  daily  ward  routine  (subject  to  such  modifications  as 
local  conditions  demand)  : 

6  a.  m. — All  Hospital  Corpsmeu  called  by  night  Hospital  Corpsmau. 

6.15  a.  HI. — Night  Ho.spital  Corpsman  calls  all  patients  permitted  to  be  up  and 
see  that  all  patients  get  attention  as  to  cleanliness. 

7  a.  m. — IMuster  of  Hospital  Corps,  followed  by  inspection  to  see  that  all  Hos- 
pital Corpsmen  are  in  their  wards  at  work.     Breakfast;  half  hour  allowed. 

7.30  a.  m. — Breakfast  for  relief  Hospital  Corpsmen ;  half  hour  allowed. 

8  a.  m. — Nurses  or  Hospital  Corpsmen  take  charge  of  ward.  Sweep  and  polish, 
and  arrange  lockers  and  chairs  in  an  orderly  manner  for  sick  call.  Take 
temperatures,  serve  medicines,  etc.  Each  Hospital  Corpsman  is  given  a  defi- 
nite' amount  of  work  and  is  to  be  held  responsible  for  that  -work.  Draw  ice 
allowance. 

8.45  a.  m. — Ho.spital  Corpsmen  and  patients  get  into  uniform  for  sick  call  at 
9  a.  m. 

9  a  ni_ — The  ward  nurse  and  senior  Hospital  Corpsman  will  accompany  the 
medical  oiiicer  holding  sick  call,  and  the  nurse  will  be  furnished  with  a  book 
in  v.-hich  she  shall  write  all  treatment  prescribed  and  which  shall  be  initialed 
by  the  ward  officer. 

9.30  a.  m.— Obtain  medicine  and  otlier  atlcles  ordered;  turn  in  morning  report 
of  patients  to  executive  surgeon.  The  wards  liaving  been  prepared,  the  heads, 
bathroom,  and  washroom,  will  be  in  readiness  for  inspection  by  the  executive 
surgeon.     Send  special  diet  sheet  to  the  commissary  department. 

10  a.  m. — Inspection  of  the  hospital  by  executive  surgeon.  Dressings  to  be  done, 
if  any,  by  nurse  or  by  Hospital  Corpsmen  under  supervision  of  nurse. 

11.30  a.  m. — Attend  to'  ward  diets  and  mess  gear.     Dinner  for  relief  Hospital 

Corpsmen. 
12  m. — Dinner  for  Hospital  Corpsmen  and  convalescent  patients. 
12.50  p.  m. — Clean  up  after  dinner. 

1  p.  m. — Take  temperatures,  serve  out  medicines,  etc. 

2  p.  m. — Police  wards. 

3  p.  m. — Sweep  or  polish  floors  as  required.    Draw  ice  for  coolers,  ice  boxes,  etc. 

4  p.  m. — Police  wards. 

4.30  p.  m. — Attend  to  ward  diets  and  mess  gear.     Supper  for  relief  Hospital 

Corpsmen. 
4.45  p.  ra. — See  that  each  patient  lias  had  his  diet,  and  clean  up  ward. 

5  p.  m. — Supper  for  Hospital  Corpsmen  and  convalescent  patients. 

G  p.  m. — Sweep  floors,  take  temperatures,  serve  out  medicines,  and  have  wards 
in  orderly  condition  for  sick  call. 

7  p.  m. — Sick  call. 

8  p.  m. — I'olice  wards. 

9  p.  m. — Report  "All  patients  accounted  for,"  or  if  there  are  any  .absentees, 
give  their  names,  rates,  etc.,  to  the  chief  pharmacist's  mate  on  watch.  Turn 
out  lights  excepting  the  standing  lights.  Hospital  Corpsmen  relievetl  by  night 
Hospital  Corpsmen. 

10  p.  m. — ^Turn  all  orders  over  to  night  nurse. 

Section  16. — Duties  of  Hospital  Cokpsmex. 

1471.  Hospital  Corpsmen  when  received  for  duty  will  be  assigned  quarters 
and  instructed  in  the  details  of  their  duties.     (See  Par.  1375.) 

1472.  Hospital  Corpsmen  who  are  in  charge  of  wards  will  be  governed  by 
the  rules  laid  down  for  nurses  in  charge  of  wards.     Hospital  Corpsmen  at- 

98601°— 17 7 


98  MANUAL   FOR   THE    MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

taclied  to  wards  will  receive  their  orders  from  the  uurse  or  Hospital  Corpsinan 
in  charge  of  ward  and  carry  out  faithfully  such  instructions  as  may  be  given 
them. 
1473.  Hospital  Corpsmen  when  off  duty  must  not  loiter  about  tlie  wards. 

Section  17. — Duties  of  the  Night  Hospital  Cobpsmajj. 

1481.  He  shall  carefully  inspect  the  building  at  stated  hours,  render  assist- 
ance to  the  night  nurse  as  required  and  carry  out  such  orders  as  may  be  given 
him.  He  has  no  authority  over  tlie  night  nurse,  but  is  responsible  for  the 
maintenance  of  order  and  discipline  on  the  part  of  Hospital  Corpsmen,  patients, 
and  employees. 

Section  18. — Example  of  Routine  fok  Sick  Officeks.     (Subject  to  such  modi- 
fication as  local  conditions  demand.) 

1491.  (a)  Morning  sick  call  will  l)e  held  at  9  a.  m.  Officers  not  in  bed  or 
excused  for  cause  will  be  up  and  dressed. 

(b)  Officer.s  must  obtain  permission  before  leaving  the  grounds  from  the 
officer  of  the  day  and  report  their  return  to  him  until  10  p.  m.,  after  which  hour 
they  will  notify  a  designated  person. 

(c)  Officers  will  notify  the  nurse  in  charge  when  they  expect  to  be  absent 
fi'om  meals. 

(d)  Smoking  in  bed  and  in  the  halls  of  the  hospital  is  prohibited. 

(e)  Patients  will  not  reprove  nurses  or  hospital  corpsmen,  but  will  report 
promptly  any  discourtesy  or  neglect  in  treatment  to  the  executive  surgeon. 

(/)  Only  hand  baggage  and  one  small  trunk  will  be  allowed  in  a  bed  room. 
Other  baggage  will  be  put  in  the  trunk  room. 

(g)  Officers  will  not  enter  the  office  ot  the  hospital  except  for  the  transaction 
of  official  business. 

(h)  Meals  will  be  served  at  the  following  hours: 
Breakfast,  8  a.  m. 
Luncheon,  12  m. 
Dinner,  G  p.  m. 
(i)   Officers  when  discharged  from  hosjutal  will  leave  an  address  at  the  offic"o 
to  which  mail  may  be  forwarded. 

Section  19. — Example  of  Rules  for  Patients.     (Subject  to  such  alterations  as 
local  conditions  may  demand.) 

1501.  Admission' of  patients.  At  regular  trips  of  the  ambulance  patients  wiil 
be  received  by  the  officer  of  the  day. 

1602.  The  master  at  arms  will,  immediately  upon  arrival  of  patients,  verify 
their  clothing  lists  from  hospital  tickets,  number  their  bags  and  hammocks  and 
transfer  them  to  the  bag  room,  enter  names  and  numbei'S  in  a  book  kept  for  that 
puipose,  and  return  the  hospital  tickets  to  the  office  for  tiling.  Patients  other 
than  bed  patients  shall  be  directed  to  take  a  tub  bath  before  entering  the  ward 
if  tills  is  deemed  necessary, 

1503.  Rules  governing  patients  in  wards.  All  patients  desiring  liberty  will 
submit  their  names  to  the  nurse  or  pharmacist's  mate  in  charge  of  w^rd  by 
S.;50  a.  UL,  who  will  prepare  a  liberty  list  for  signature  by  ward  officer  at  sick 
call  (9  a.  m.)  when  it  shall  be  forwarded  to  the  general  office  to  l)e  entered  on 
(he  liberty  book  for  tinal  approval  by  the  executive  surgeon.  Requests  for 
extension  of  leave  by  telephone  will  be  disregarded  excepting  In  cases  of 
emergency.  ,  „    .  x, 

1501.  Patients  will  be  inspected  before  leaving  hospital  to  see  that  they  are 
in  correct  uniform  and  upon  return  will  i-eport  to  the  officer  of  the  day  until  ]0 
p.  m.  and  after  that  to  a  designated  person.  The  condition  of  patients  return- 
ing will  be  noted  In  the  liberty  book. 


MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 


99 


1605.  Patients  with  venereal  diseases  will  not  be  allowed  general  libei-ty.  ami 
their  names  will  not  be  entered  on  the  liberty  list. 

1506.  Patients  desiring  to  remove  packages  from  the  hospital  reservation 
will  be  provided  with  passes  by  the  officer  of  the  day. 

1507.  Convalescent  patients  detailed  for  work  in  a  ward  may  be  called  upon 
by  the  nurse  or  pharmacist's  mate  in  charge  for  any  light  duty  she  or  he  may 
order  them  to  perform.  Convalescent  patients  for  other  than  ward  duty  will 
receive  their  orders  from  the  master  at  arms. 

1508.  Patients  are  permitted  to  smoke  only  in  places  designated  for  that 
purpose. 

1509.  Patients  are  not  allowed  to  play  cards  or  other  games  in  the  wards 
without  special  permission. 

1510.  Patients  are  not  allowed  to  sit  on  the  sides  of  beds,  and  those  able  to 
be  up  and  about  are  not  allowed  to  lie  on  their  beds  without  removing  shoes  and 
neatly  turning  down  the  spread. 

1511.  The  following  articles  and  no  others  will  be  allowed  to  be  kept  by 
patients  in  their  lockors : 


BLUEJACKETS. 

Suit  of  blue  or  white 1 

Suits  of  underclothing 2 

Socks,  pair 3 

White    hat 1 

Blue   hat 1 

Neclverchief 1 

Towels 3 

Shoes,  pair 1 

Toilet  articles. 


MARINES. 

Suit  of  blue  or  khaki .  1 

Suits  of  underclothing 2 

Socks,   pair .3 

Shirts ■:  '  2 

Blue   cap . 1 

Towels :-< 

Shoes,  pair , 1 

Toilet  articles. 


1612.  Lockers  umst  be  kept  in  a  neat  condition  and  be  thoroughly  overhauled 
and  washed  weekly. 

1513.  Patients  should  not  talk  loudly  or  make  unnecessary  noises  in  any 
part  of  the  hospital. 

1514.  Patients  are  advised  to  deposit  all  money  and  valuables  in  the  hospital 
safe,  receipt  being  given. 

1516.  No  fruit,  candy,  eatables,  or  liquors  (alcoholic  or  other)  are  to  be  taken 
into  the  ward  without  permission  of  the  officer  of  the  day. 

1516.  Patients  are  to  be  always  in  the  prescribed  uniform. 

1517.  Patients  are  not  allowed  to  congregate  about  the  ward  desk,  nor  enter 
Hospital  Corps  quarters. 

1518.  Patients  are  not  allowed  to  wash  clothes  In  the  wards  or  bathrooms. 
1611).  Each  patient  in  ward  will  be  supplied  with  a  drinking  glass. 

1520.  Patients  will  avoid  leaving  matches,  papers,  or  any  rubbish  on  the 
floors  of  the  wards  or  throwing  them  out  of  the  windows,  and  any  articles  of 
such  a  character  found  on  the  floors  or  elsewhere  shall  be  removed  by  the 
patient  whose  bed  is  nearest  the  place  where  they  are  found. 

1621.  Convalescent  patients  will  be  held  responsible  for  the  making  up  of 
their  beds,  their  neat  appearance,  and  the  cleanliness  of  the  immediate  neigh- 
borhood. 

1522.  When  a  patient  is  transferred  from  one  ward  to  another  he  shall  be 
accompanied  by  a  slip  stating  his  previous  treatment,  diet,  etc. 

1523.  Patients  will  observe  strictly  these  and  other  rules  issued  for  ttleir 
guidance  by  competent  authority. 

1524.  Dischstrge  of  patients.  Wlien  a  patient  is  to  be  discharged  from  the 
hospital,  he  shali  remove  soiled  bed  linen,  wash  and  thoroughly  clean  his  bed 
and  locker,  carry  the  mattress  to  sterilizer  room  if  directed,  and  return  to  the 
nurse  or  pharmacist's  mate  in  charge  all  towels,  pajamas,  slippers,  or  other 
hospital  property  he  may  have  in  his  possession. 


lOU         MXSVAL    FOR    TilE    MKDIGAL    DEPARTMENT,   U.    S.    NAVY. 

1525.  The  niastor  at  arms  will  cherk  each  departiiis;  patient's  olothin?  list, 
have  him  si.mi  the  ro<eii)t  on  baclc  of  the  hospital  ticket,  and  see  that  he  is  in 
the  nniforni  of  the  day. 

152(>.  I'atit'nts  discharged  from  the  hospital  should  leave  their  futnro  address 
at  the  general  oilice  so  that  mail  may  be  forwarded. 

1527.  Montldy  money  lists  and  small-store  requisitions  will  be  prepared  after 
approval  by  the  executive  surgeon  at  designated  times. 

1528.  The  names  of  patients  recommended  for  medical  survey  will  be  noted 
on  the  mornins  report  of  patients  on  Mondays,  and  patients  fit  for  duty  will 
likewise  be  noted  on  Tuesdays  and  Thursdays  and  will  usually  be  discharged 
on  Wednesdays  and  Fridays. 

Section  20. — Instkuctions  Hegakding  Supernumkr.\ries,  Pensioners,  etc.,  in 

Hospitals. 

•n 

1531.  Supernumeraries  may  be  taken  to  include  all  per-sons  admitted  to  hos- 
pital for  treatment,  except  officers  and  men  of  the  Na^•^'  or  Marine  Corps  on 
the  active  list.  Retired  officers  and  men,  officers  and  men  of  the  Navai 
Reserve  Force  and  the  Naval  Auxiliary  Service,  members  of  the  Nurse  Corps, 
civil  employees,  officers  and  enlisted  men  of  the  Army,  Coast  Guard,  Coast 
and  Geodetic  Survey,  and  other  Federal  services,  Federal  services  of  friendly 
powers,  and  natives  treated  in  the  insular  dependencies  may  be  considered 
supernumeraries. 

1582.  For  methods  of  keeping  the  medical  records  of  supernumeraries,  see 
pars.  2245,  2247.  221)3,  2365. 

1533.  («)  When  ueces.sary  in  emergency,  supernumeraries  may  be  admitted 
to  hospital  for  treatment  subject  to  the  bureau's  approval,  but  ordinarily  per- 
lulssion  for  the  admission  of  supernumeraries  should  be  obtained  in  atlvance, 
except  in  the  case  of  a  retired  officer  or  enlistefl  man.  Specific  authority  for 
the  retention  in  hospital  of  enlisted  men  after  the  expiration  of  enlistment  is 
unnecessary,  but  a  return  should  be  made  to  the  bureau,  through  the  com- 
mandant, of  all  supernumeraries  so  retained.  (  R.  3582  i7)  );  (I  5247  (52). » 
The  return  referred  to  in  I  5247  (52)  shall  take  the  form  of  a  notification 
to  the  bureau  when  enlisted  men  are  retained  after  expiration  of  enlistment 
and  the  form  of  a  request  in  all  other  cases. 

ib)  Article  R  36G7  authorizes  any  person  honorably  discharged  from  the 
naval  service  to  elect  a  home  on  board  a  receiving  ship  at  any  time  iluring 
the  four  months  immediately  subsequent  to  his  discharge,  and  each  person  so 
electing  a  homo  on  board  a  receiving  ship  is  allowed  one  ration  and  is  re<piired 
to  wear  the  uniform  of  tlie  naval  .service.  Wliile  enlisted  men  are  nuUilng 
tlieir  homes  on  board  receiving  ships  pending  reeiilistment  or  for  other  pur- 
po.ses  they  are  recognized  as  being  wards  of  tlie  Navy  and  are  in  the  Navy  so 
fur  as  concerns  receiving  quarters  and  rations,  and  if  sick  or  injured  (hning 
such  period  nnist  receive  medical  treatment  on  board  the  re('<Mving  ship  or  at  a 
naval  hospital,  and  shall  be  considered  supernumeraries.     (M.  &  S.  No.  12(')472. ) 

1534.  Retired  enlisted  men  of  the  Marine  (Jori)s  while  supernumeraries  in 
naval  ho.<;pitals  should  make  immediate  settlement  in  cash  for  rations  furnished 
them,  or  if  preferred,  ration  notices  may  be  .sent  to  the  pay  officer  having  the 
accounts  of  the  men  in  question,  who  will  make  proper  checkage  against  their 
pa.Y  and  allowances.  Enlisted  men  of  the  Marine  Corps  after  retirement  re- 
ceive in  addition  to  pay  a  money  iillowance  as  comnnitfttlon  of  clothing,  light, 
heat,   and   rations, 

1535.  Article  K  4533,  Navy  Regulations,  1913,  pre.stribes  (hat  whenever  any 
officer,  seaman,  or  marine  entitled  to  a  jiension  is  ailmitted  to  u  naval  hospital, 
his  pension  while  he  remains  there  shall  be  deducteil  from  his  account  and 
paid  to  the  Secretary  of  the  Navy  for  the  benefit  of  the  fimd  from  which  such 
liospital  is  maintained  (naval  lio.sj)ital  fund).  Whenever  a  pensioner  is  ad- 
mitted to  a  naval  hospital  report  slioidd  be  made  by  the  medical  ellicer  in 
command  to  the  Honorable  ( 'nnimis.sioner  of  ren.sions  tlirect,  giving  the  pensiou- 
er's  name,   r.ink  or  rating,   and  pi-iisioii   rmmber.      (See  al.so  chap.  23,  sec.  7.) 


MANUAL    FOR    THE    MEDICAL    DEPABTMSNT,   U,    S.    NAVY.        101 

Section  21. — Civil  Employees  at  Hospitals. 

1541.  Civil  employees  at  naval  hospitals  are  allowed  15  days'  leave  with  pay 
yearly.  During  this"  leave,  if  their  work  is  of  such  a  character  that  it  can 
not  be  done  by  other  employees,  a  temporary  employee  may  be  taken  on  the 
rolls  at  a  rate  of  pay  not  in  excess  of  the  established  pay  of  the  rating.  (M.  & 
S    Xo    124942. ) 

'  1542. 'civilian  employees  (except  those  in  the  culinar>-  force  who  will  be 
under  the  pharmacist,  when  a  pharmacist  is  attached  to  the  hospital)  shall 
be  under  the  direct  supervision  of  the  executive  surgeon  and  he  shall  require 
the  chief  engineer,  carpenter,  painter,  and  outside  foreman  to  report  to  him 
daily  at  a  designated  hour  to  give  au  account  of  any  work  under  way  and 
receive  orders  for  work  to  be  done,  and  also  report  the  absence  or  tardiness 
of  any  employees  under  them. 

154.3.  Artisans  and  laborers  employed  at  naval  hospitals,  naval  meilical 
supply  depots,  and  the  Naval  Medical  School  jare  entitled  to  receive  compen- 
sation under  the  act  of  May  30,  1908,  for  injuries  received  in  the  course  of 
their  employment. 

Section  22. — The  Dispensary. 

1551.  The  dispensary  shall  be  in  charge  of  a  chief  pharmacist's  mute,  who 
will  be  held  responsible  for  its  cleanliness  and  general  management.  One 
pharmacist's  mate,  if  possible,  shall  be  detailed  for  instruction  in  the  dispensary, 
the  period  of  instruction  to  be  the  same  as  that  of  the  operating  room  pharma- 
cist's mate.  The  chief  pharmacist's  mate  in  charge  of  the  dispensary  shall 
draw  the  necessary  drugs  and  supplies  from  the  property  pharmacist's  mate 
at  designated  hours.  No  prescription  shall  be  tilled  or  material  issued  except 
on  an  order  of  a  medical  officer  attached  to  the  hospital.  The  chief  pharma- 
cist's mate  in  charge  of  the  dispensary  shall  issue  drugs  and  fill  prescriptions 
for  the  wards  at  a  designated  hom-  and  deliver  them  to  wards  as  soon  as 
possible. 

Section  23.— The  X-ray  Room. 

1561.  The  X-ray  room  sliall  be  under  the  direct  care  and  supervision  of  a 
medical  officer.  A  chief  pharmacist's  mate  shall  be  detailed  for  duty  in  the 
X-ray  room,  and  at  least  one  pharmacist's  mate  shall  be  kept  under  instruc- 
tion there.  '  This  work  may  be  combined  with  the  duties  of  the  property 
steward.  The  Hospital  Corpsman  under  instruction  will  act  as  general  assist- 
ant to  the  property  pliarmacist's  mate,  and  will  have  charge  of  the  hydrotherapy 
room,  and  will  be  carefully  instructed  in  the  use  of  the  apparatus  under  his 
control.     A  complete  record  will  be  kept  of  all  work  done  in  the  X-ray  room. 

Section  24. — The  Linen  Room. 

1571.  The  linen  room  shall  be  under  the  supervision  of  the  chief  nurse,  and 
when  practicable  a  nurse  shall  be  assigned  to  assist  her  and  have  charge.  If 
a  nurse  is  not  available,  a  chief  pharmacLst's  mate  or  pharmacist's  mate  shall 
be  in  charge.  Linen  will  be  obtained  from  the  property  pharmacist's  mate  when 
necessary  to  keep  up  stock.  Each  ward  Avill  have  a  definite  allowance  of  linen, 
and  this  shall  be  inventoried  monthly  by  the  nurse  in  charge  of  the  ward. 
Articles  for  survey  will  be  replaced  by  use  of  the  property  accountability  slip. 

Section  2.5. — The  Diet  Kitchen. 

1581.  The  diet  kitchens  shall  be  under  the  supervision  of  the  chief  nurse, 
assisted  by  a  nurse  detailed  for  that  purpose  when  practicable.  The  articles 
of  food  required  for  diet  kitchens  will  be  issued  from  the  commissary  depart- 
ment on  property  accountability  slips.  .As  many  dishes  of  special  nature  as 
possible  shall  be  prepared  in  diet  kitchens  to  relieve  the  main  kitchen  of  this 
work. 


1-02        MANUAL   FO.R   TH'E   MEDICAL   DEPARTMENT^   U.    S.    NAVY. 

Section  26. — Thk  Akmy  and  Navy  PIospitai.,  Hoi'  Springs,  Ark. 

1591.  Erection  of  an  Army  and  Navy  Hospital  at  Hot  Springs,  Ark.  Act 
June  30,  18S2  (Army  appi-opriation  act). 

15*J*2.  Composition  of  board  desifrnated  to  draft  rules  for  its  government. 
Executive  order,  May  6.  1886. 

Skution  27. — Navy  Regulations  and  Dei'aktaikntal  Cibculars  Relating  to 
THE  Admission  of  Patients  to  the  Akmy  and  Navt  Hospital,  Hot  Spkinos, 
Abk.  •■\' 

!) 

1601.  Authority  for  admission,  how  obtained.    R  4531  (1).  .'> 

1602.  Accommodations,  how  assl3:ned  to  the  services.    R  4531  (2).  ■>■• 

1603.  Rules  governing  the  admission  of  patients,  department  circular,  Decem- 
ber 31,  1886  (summarized  below)  : 

Section  28. — Information  Relating  to  the  Admission  of  Patients  to  thb 
Akmy  and  Navy  Hospital,  Hot  Springs,  Ark. 

1611.  The  hospital  is  under  the  direction  of  the  Secretary  of  War,  and  is 
devoted  to  the  treatment  of  officers  and  enlisted  men  of  the  military  and  naval 
services  of  the  United  States,  officers  of  the  Revenue-Cutter  Service,  and  of  the 
Public  Health  Service,  and  honorably  discharged  soldiers  and  sailors  of  the 
Regular  and  Volunteer  Army  and  Navy  of  the  United  States,  for  such  pur- 
poses as  the  waters  of  the  Hot  Springs  of  Arkansas  have  an  established  repu- 
tation in  benefiting,  except  that  cases  of  venereal  diseases  will  not  be 
admitted. 

1612.  Admission  to  this  hospital  is  restricted  to  those  of  the  above-named 
classes  who  require  medical  treatment  in  the  following  order  of  preference: 
(1)  Officers  and  enlisted  men  of  the  Army,  Navy,  and  Marine  Corps  on  the 
active  lists,  cadets  at  the  Military  Academy,  and  midshipmen  at  the  Naval 
Academy;  (2)  officers  and  enlisted  men  of  the  Army,  the  Navy,  and  the  Marine 
Corps  on  the  retired  lists;  (3)  officers  of  the  Coast  Guard  and  the  Public 
Health  Service;  (4)  honorably  discharged  soldiers  and  sailors  of  the  Regular 
and  Volunteer  Army  and  Navy  of  the  tTnited  States  may  also  be  admitted  by 
authority  of  the  Surgeon  General  when  there  are  vacant  beds  in  the  hospital. 

1618.'  Officers  and  enlisted  men  of  the  Navy  and  Marine  Corps  are  admitted 
under  regulations  prescribed  by  the  Secretary  of  the  Navy. 

1614.  Honorably  discharged  soldiers  and  sailors  of  the  Regulars  and  Volun- 
teer Armv  and  Navy  of  the  United  States  are  admitted  upon  the  approval  of 
the  Surgeon  General  of  the  Army,  from  whom  blank  forms  of  application  can 
be  obtained.  These  must  be  properly  filled  out.  giving  all  necessary  informa- 
rioii  in  relation  to  the  applicant,  and  should  be  certified  to  by  a  practicing  phy- 
sician, who  will  state  the  nature  of  the  disability  and  the  probable  period 
required  for  hospital  treatment.  Patients  admitted  under  this  authority  may 
be  discharged  from  the  hospital  by  the  commanding  officer  at  any  time  he  may 
deem  proper.  Expenses  to  and  from  the  ho.spital  must  be  defrayed  by  the 
appli«ant. 

1615.  Enlisted  men  on  the  active  list  under  treatment  or  on  duty  or  mem- 
bers of  the  Nur.se  Corps  on  duty  in  the  hospital  will  have  the  usual  allowance 
of  rations  commuted  at  the  rate  of  not  le.ss  tlian  30  cents  per  day  for  enlisted 
men  and  40  cents  for  inenil»ors  of  tli(>  Nurse  Corps.  Enlisted  men  of  the  .\rniy, 
Navy,  and  Marine  Corps  on  the  retired  list  and  honorably  dischargeil  soldiers 
and  sailors  of  tbe  Regular  and  Volunteer  Army  and  Navy  of  the  United  States 
will  pav  for  subsistence  40  cents  per  day. 

1616.  In  f.ertit'ying  cases  for  admission  to  this  hospital  medical  officers  and 
physicians  should  recommend  only  those  that  are  serious  and  obstinate,  and 
In  wtiich  there  is  a  reasonable  prol>ability  that  the  facilities  there  afforded  will 
ma/^erially  aid  in  the  rapidity  and  permanence  of  recovery. 


MANUAL    FOE    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.        103 

1617.  Relief  may  reasonably  be  expected  at  the  Hot  Springs  in  the  following 
conditions:  lu  the  various  forms  of  gout  and  rheumatism,  after  the  acute  or 
inflammatory  stage;  neuralgia,  especially  when  depending  upon  gout,  rheuma- 
tism, metallic,  or  malarial  poisoning ;  paralysis  not  of  organic  origin ;  the 
earlier  stages  of  locomotor  ataxia;  chronic  Bright's  disease  (the  early  stages 
only),  and  other  diseases  of  the  urinary  organs;  functional  diseases  of  the 
liver;  gastric  dyspepsia  not  of  organic  origin;  chronic  diarrhea,  catarrhal 
affections  of  the  digestive  and  respiratory  tracts;  chronic  skin  diseases,  espe- 
cially the  squamous  varieties ;  and  chronic  conditions  due  to  malarial  infection. 

1618.  No  officer  or  enlisted  man  of  the  Navy  or  Marine  Corps  shall  be 
admitted  as  a  patient  into  the  Army  and  Navy  Hospital  until  he  has  been  con- 
demned by  a  board  of  medical  officers  and  the  report  of  such  board  has  been 
approved  by  the  department. 

1619.  If  it  is  not  practicable  to  convene  a  board  of  medical  officers  for  this 
purpose,  the  certificate  of  a  naval  medical  officer  or  that  of  a  civil  practitioner 
should  be  forwarded  to  the  department,  giving  a  full  description  of  the  disa- 
bility under  which  the  patient  is  suffering. 

1620.  Upon  approval  by  the  department  of  the  report  of  medical  survey,  the 
Bureau  of  Medicine  and  Surgery  will  forward,  through  official  channels,  to  the 
patient  an  order  for  his  admission  into  the  hospital. 

1621.  The  commanding  officer  of  the  Army  and  Navy  Hospital  (through  the 
Surgeon  General  of  the  Army)  is  informed  of  the  action  taken  by  the  Bureau 
of  Medicine  and  Surgery. 

1622.  On  admission  to  the  Army  and  Navy  Hospital  the  patient  shall  present 
for  the  information  of  the  hospital  authorities  the  following  papers  relating 
to  his  case : 

(a)    Order  for  admission. 

lb)  Copy  of  report  of  medical  survey   (if  recommended  by  medical  survey). 

(c)  Health  record  (if  patient  is  on  active  list). 

(d)  Copy  of  hospital  ticket  (if  transferred  from  a  ship,  navy  yard,  or 
special  duty). 

(e)  A  statement  of  patient's  condition  (if  admitted  upon  the  certificate  of 
a  civil  practitioner). 

Section  29. — Infoemation  Relating  to  the  Admission  of  Patients  to  the 
United  States  Naval  Home. 

1631.  The  regulations  for  admission  to  the  Naval  Home  require  that  a  per- 
son shall  have  served  20  years  in  the  Navy  or  Marine  Corps  and  be  disabled 
from  earning  his  living  by  manual  labor.  However,  it  is  customary  for  the 
Secretary  of  the  Navy  to  waive  the  20-year-service  requirement  where  the 
applicant  for  admission  to  the  Naval  Home  has  rendered  somewhere  near  the 
required  number  of  years  service,  has  a  creditable  record,  and  has  been  dis- 
charged for  disability,  or  where  he  has  served  a  number  of  years,  has  an 
exceedingly  meritorious  record,  and  is  disabled  in  the  line  of  duty. 

1632.  Boards  of  medical  survey  in  the  cases  of  men  whom  it  is  contemplated 
discharging  from  the  service  should  give  the  patient  when  practicable  the 
choice  of  being  discharged  from  the  service  or  of  being  transferred  to  the  naval 
hospital,  Philadelphia,  Pa.,  preliminary  to  his  admission  to  the  Naval  Home, 
and  it  is  suggested  that  such  boards  enter  their  recommendations  on  the  sur- 
vey accordingly.  Upon  the  arrival  of  the  patient  at  the  naval  hospital,  Phila- 
delphia, the  necessary  applications  for  admission  to  the  Naval  Home  will  be 
made  out  for  him  there. 

1633.  Inmates  of  the  Naval  Home  are  given  a  clothing  allowance  of  about 
$50  a  year,  li  pounds  of  tobacco  a  month,  and,  if  not  in  receipt  of  a  pension,  are 
allowed  $3  per  month  pocket  money.  Pensioners  in  the  home  are  allowed  to 
draw  their  pensions.  Each  man  is  quartered  in  a  separate  room.  Those  who 
are  able  to  work  and  desire  to  do  so  are  employed  about  the  buildings  and 
grounds  as  watchmen,  gatekeepers,  etc.,  for  which  they  are  paid  from  $10  to 
$15  a  month. 


;.U 


'iaa  aA  ) 


CHAPTER  9. 


HOSPITAL  SHIPS. 
Section  1. — Navy  Regulations  and  Instructions  Relating  to  Hospital  Ships. 

1701.  Bureau  of  Medicine  and  Surgery  to  approve  the  design  of  liospital 
ships  and  liave  control  of  tlieir  internal  organization  and  administration.  R 
]33  (3)  ;  R  2901  (1)  ;  R  2911. 

1702.  Designation,  duties,  and  cognizance  of  hospital  ships.    R  2911. 

1703.  Persons  transported  restricted.    R  2912. 

1704.  Regulations,  instructions,  and  conventions  governing.     R  2913. 

1705.  Assimilated  to  shore  hospitals  and  manned  by  merchant  crew  and 
Hosiiital  Corps.    R  2914. 

1706.  Classed  as  naval  auxiliaries.     R  2915. 

1707.  Characteristic  painting  required.     R  2916. 

1708.  Neutralization  rules.     R  2917   (1-3). 

1709.  Hospital  ships  subject  to  inspection  by  commander  in  chief.  R2918; 
I  908. 

1710.  Commanding  officer  and  succession  to  command.     R2919  (1)  (2). 

1711.  Orders  to  hospital  ships.     R  2919  (3). 

1712.  .Junior  medical  officers.     R  2920. 

1713.  Traffic  forbidden.     R  2921. 

1714.  Intoxicating  liquor  forbidden.     R  2922. 

1715.  Civilian  complement,  how  classified.     R  2923. 

1716.  Authorities   and   duties,   etc.,   of   masters  of   hospital   ships.      R2924 

(1-16). 

1717.  Responsibility  and  duties  of  first  officer.     R  292.5. 

1718.  Responsibility  and  duties  of  chief  engineer.     R2926. 

Section  2. — Naval  Instructions  Relating  to  Hospital  Ships. 

1721.  Arrangement  of  mes.ses.     14001. 

1722.  Boat  instruction.     14002. 

1723.  Signals  used  and  instruction  in  signaling.     14003. 

1724.  Accounts  of  officers  and  men  carried  on  a  designated  naval  vessel. 
I  4004. 

1725.  Subsistence  and  issues.     14005;  14549  (1)  ;  14951. 

1726.  Accounts  of  master.     14006. 

1727.  Shipments,  appointments,  discharges,  uniforms,  etc.,  governed  by  Reg- 
ulations for  Naval  Auxiliary  Service.    I  4007. 

1728.  Hospital  ship  regulations  to  govern  civilian  crew.     14008. 

1729.  Obedience  to  authority  enjoined.     14009. 

1730.  Deportment  required  to  be  civil  and  decorous.     14010, 

1731.  Uniforms.     14011. 

1732.  Improper  conduct  forbidden.     I  4012. 

105 


106        MANUAL   FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

1733.  Smoking  rules  and  other  roKulatioiis.     I  4013. 

1734.  Oflicer  and  quartermaster  always  on  duty  in  port.     14014. 
1785.  Harbor  regulations  regarding  refuse  to  be  observed.     I  4015. 
1730.   Ship's  log.     I401G. 

1737.  Duties  of  the  master.    I  4017  (1-7). 

1738.  Duties  of  the  first  officer.    I  4018  .(1-6). 
1730.   Duties  of  the  deck  officer.    14019. 

1740.  Duties  of  the  chief  engineer.     I  4020  (l-ll). 

1741.  Medical  officer  in  command  to  make  the  same  reports  as  are  re(iuired 
from  naval  hospitals.     I  5231,       ,■>    >Mi'J '^AHJ 

1742.  Medical  officer  in  command. 

(a)  Relations  with  master.    I  4230. 

(b)  Authority  to  relieve  master  of  his  duty.    I  4232  (1). 

1743.  Responsibility  of  master.    14231  (1). 

1744.  Reporting  position  by  radio.    General  Order  No.  130. 

1745.  Transfer  of  patients  to  hospital  sliips,  see  chapter  17,  section  9.    >i .     ' 
1740.  Transfer  of  dead  to  hospital  ships,  see  chapter  20,  section  12. 


/IK 


CHAPTER  10. 


ORGANIZATION  OF  THE  MEDICAL  DEPARTMENT  FOR  THE  CARE  AND 
DISPOSITION  OF  THE  WOUNDED  AFLOAT  AND  IN  EXPEDITIONARY 
SERVICE  ON  SHORE. 

Skction  1. — Navy  Regulations  and  Naval  Insteuctions  Relating  to  Peepa- 

EATION    FOB   AND   THE   CONDUCT   OF   THE   MeDICAL   DePAKTMENT   IN    BATTLE   AND 

Subsequent  to  Battle. 

ISOl.  Medical  Department  is  charged  witli  making  provisiou  for  cave  of 
wounded  in  battle.    R2901  (1). 

1802.  Hospital  ships  to  care  for  and  transport  the  wounded.     R  2911. 

1803.  Medical  officer  of  a  ship  to  malie  suggestions  regarding  care  and  com- 
fort of  wounded.    R  2954. 

1804.  Medical  officer  to  be  in  readiness  for  relief  of  wounded  and  instruct 
ambulance  party  in  fii'st  aid.    R  2956. 

1805.  After  battle  medical  officer  to  make  duplicate  report  of  killed  and 
wounded.    R2957;  R2061  (3). 

1806.  Chaplain's  duty  and  station  in  battle.    R3102. 

1807.  Red  Cross  cooperation  in  war.    R  3861. 

1808.  Fleet  surgeon  to  make  a  tabulated  report  of  killed  and  wounded  in 
action.    I  1122  (7). 

1800.  Executive  officer's  report  after  battle.    I  1407. 

1810.  Distribution  of  first-aid  appliances  and  instruction  in  first-aid.     I  2109. 

1811.  Medical  officer's  duty  to  wounded  in  battle.    12128. 

1812.  Station  of  pay  division  in  battle.    12203  (4). 

1813.  First-aid  instruction  to  men  by  divisional  officer.    12641. 

1814.  Instruction  to  Hospital  Corps  in  first-aid  and  transportation  methods. 
I  2642. 

1815.  Reports  from  officers  after  battle.    I  5327. 

1816.  Report  of  casualties  in  action.     (Form  K2.)     I  5222  (5)r. 

Section  2. — Detailed  Oeganization  fob  Relief  of  Wounded  Aboard  Ship. 

1821.  The  regulations  require  that  the  medical  officer  shall  frequently  advise 
the  divisional  officers  in  the  use  of  first-aid  appliances.  These  include  shell 
wound  dressings,  designed  to  protect  wounds  caused  by  shell  fragments,  and 
tourniquets  for  control  of  hemorrhage.  Iii  addition,  instruction  in  resusci- 
tation of  the  apparently  drowned  is  given.  Medical  officers  should  prepare 
lists  of  fractures,  wounds,  burns,  scalds,  etc.,  of  various  parts  of  the  body, 
and  drill  Hospital  Corps,  relief-station  crews,  and  stretcher  bearers  in  these 
subjects.  When  a  yeoman  is  detailed  to  help  with  the  clerical  work  he  should 
be  instructed  in  spelling  the  various  diagnoses,  taught  the  key  letters,  and  also 
such  blank  forms  of  the  Medical  Department  as  may  be  used,  should  be  fully 
explained.  Where  training  in  the  use  of  rescue  breathing  apparatus  is  given, 
this  shall,  in  all  cases,  be  undertaken   in   the  presence  of  a  medical  officer 

..U   iO  ei-li;iiUi;>107 


108         MANUAL    FOR    THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY. 

(Ceneral  Order  No.  118,  Sept.  15,  1914).  The  divisional  officers  in  turn  give 
instruction  to  the  men  under  their  innnediate  command.  (I  2109  ;  I  2641.)  The 
medical  officer  also  provides  for  the  instruction  in  first-aid  and  trauhpoitation 
methods  of  the  Hospital  Corps  and  stretolu-r  men  in  number  equal  to  about  2 
per  cent  of  the  coinplement  of  the  ship.  (R2956.)  Turrets,  handling?  rooms, 
gun  stations,  torpedo,  fire,  and  engine  rooms,  and  fire-control  stations  and  other 
stations  not  readily  accessible,  in  which  men  and  officers  are  stationed  in 
liattle,  should  be  provided  with  first-aid  packap:es,  shell-wound  dressings,  and 
tourniquets.  Dressings  for  burns  and  scalds  in  engine  and  fire  rooms,  plainly 
labeled,  should  be  accessible  to  the  occupants  of  these  stations.     (See  par.  ](>(»8.  )- 

1S22.  (d)  Modern  naval  warfare  presupposes  a  high  casualty  rate  and  a 
rapid  accumulation  of  womuled,  but  the  casualty  rate  will  vary  widely  on 
different  ships,  probably  being  highest  in  the  leading  divisions.  Any  effective 
organization  of  medical  personnel  to  meet  the  demands  of  the  woun«lod  in  a 
naval  engagement  will  usually  go  beyond  the  facilities  of  a  single  ship  and  will 
necessitate  the  adoption  of  a  "more  comprehensive  scheme  of  assistance  external 
to  the  ship,  but  every  vessel  should  be  self-sustaining  so  far  as  practicable,  and 
no  effort  should  be  spared  to  attain  this  end.  When  the  ship's  band  is  detaile<l 
to  the  ambulance  party  its  members  should  receive  systematic  instruction  in 
first-aid  and  nursing  so  that,  besides  acting  as  stretcher  bearers,  its  members 
may  be  able  to  supplement  in  some  measure  the  Avork  of  hospital  corpsnien  dur- 
ing action.  Stretcher  bearers  should  b"  thoroughly  familiar  with  all  passage- 
ways and  ladders  leading  to  dressing  stations  from  various  parts  of  the  .ship. 
When  wide  dispersion  of  the  ships  or  other  conditions  render  outside  assistance 
unavailable,  the  measures  to  be  adopted  by  the  ship's  resources  alone  during 
and  subsequent  to  battle  will  comprise  the  following: 

(b)  Continuous  first-aid  service  to  the  wounded  during  battle  on  the  part  of 
the  personnel  at  large.  The  effectiveness  of  this  service  will  depend  largely 
upon  the  thoroughness  with  which  the  units  have  previously  been  instru<'te<l  by 
the  medical  and  divisional  officers,  as  required  under  the  regulations,  and  how 
well  they  have  become  imbued  with  the  principle  that  first-aid.  calmly  adminis- 
tered by  themselves  or  comrades,  represents  the  maxinmm  service  that  can  be 
rendered  the  wounded  during  the  height  of  a  naval  action.  Tlie  ships  force 
should  have  been  warned  that  elabcn-ate  measures  of  treatment  or  extensive 
transportation  during  battle  are  both  inadvisable  and  impracticable  Tiic 
wounded  man,  after  the  administration  of  first-aid,  should  be  placed  to  one  side, 
where  his  presence  will  be  least  felt  and  where  he  will  not  incommode  or  dis- 
turb the  fitrhting  force. 

(n)  In  a  suspension  or  lull  of  the  battle  or  after  the  engagement,  upon  notice 
from  the  central  station,  and  when  prompt  treatment  of  the  wounded  \u  or  near 
the  fighting  position  is  denied  or  deferred  for  any  reas-.n.  the  strctclier  men 
may  be  required  to  seek  out  and  transport  certain  of  the  wounded  to  the  battle 
dressing  stations.  It  should  be  the  first  duty  of  the  medical  officer  to  give  at- 
tention to  such  of  the  wounded  as  may  render  further  service  at  the  guns  or 
clsewliere  after  the  application  of  the  appropriate  treatnieni-.  These  men  should 
be  pr('iiii>tlv  returned  to  their  stations.  It  must  be  borne  in  mind  that  the 
primary  purpose  of  first-aid  Is  to  keep  as  many  effectives  at  their  stations  as 
possil)ie.  A  graver  class  of  injuries  may  require  deliberate  surgical  interven- 
tion, but  extensive  procedures  on  the  part  of  the  sidji's  force  are  otily  legitimate 
if  evacuation  of  the  wounded  for  any  reason,  is  dehiyed  or  rendered  inadvisable. 
The  personnel  of  the  Medical  Department  slionld  institute  a  searcii  for  the  seri- 
<(usly  wounded  to  afford  them  relief  and  to  prepare  a  list  of  the  dead  as  soon 
as  practicable.  To  assure  the  woutuled  early  and  efficient  treatment,  eff»M«t  tlieir 
rapid  removal  from  the  figliting  ship,  and  insvn-e  a  .-ontinuous  record  of  each 
case  is  the  object  of  the  organization. 

1823.  General  quarters:  When  at  exercise  sinnilating  action  (In  so  far  as 
it  Is  possible  to  do  so),  the  medical  officer  will  employ  this  op|-H>rtunity  to  in- 
struct the  personnel  of  the  dressing  stations  In  their  duties,  assuring  himself 
that  all  members  of  the  ambulance  party  are  competent  to  administer  lirst-aid; 


MANUAL    FOR    THE    MEDICAT     DEPARTMENT,   V.    S.    NAVY.        109 

tliat  they  understand  their  stations  and  the  limits  of  the  ship  assigned  to  tliem, 
and  the  usual  routes  of  transpoit  to  and  from  the  groups  of  personnel.  At  drill, 
the  dressing  stations  will  not  be  equipped  in  advance  of  signal  "  general 
quarters." 

1824.  Battle  dressing  stations: 

(a)  Battle  dressing  stations  should  be  easy  of  access  and  located  behind 
armor.  Routes  to  dressing  stations  should  be  indicated  by  an  arrow  and  a  red 
cross.  There  should  be  at  least  two.  one  being  installed  as  a  main  or  primary 
station  and  one  as  an  accessory  or  secondary  station.  The  stations  should  have 
an  abundant  supply  of  drinking  water,  all  connections  being  installed  behind 
armor.  As  these  connections  might  nevertheless  be  interrujited  storage  tanlcs 
for  drinking  water  should  be  provided  having  a  capacity  sufficient  to  furnish 
in  first-class  ships  1  gallon  of  water  per  man.  allowing  for  20  per  cent  of 
wounded.  Dre.ssing  stations  should  also  be  well  ventilated,  well  lighted,  and  as 
cool  as  the  surroundings  will  permit.  It  has  been  estimated  that  each  3C 
square  feet  of  area  should  Ije  provided  with  one  cargo  light  of  apiiroximately 
200  candlepower  (6  lamps).  If  possible,  connections  for  electric  lights  should 
be  distributed  on  two  circuits ;  lanterns  or  some  other  means  of  lighting  should 
1)0  available  in  case  the  electric  lighting  circuits  suffer  interruption.  Electric 
or  steam  connections  should  be  provided  for  the  water,  dressing,  and  instrument 
sterilizers.  In  ships  wherein  proper  connections  are  provided  sterilizers  should 
be  removed  from  the  surgical  operating  room  and  set  up  in  the  main  dressing 
station  prior  to  action.  When  so  installed  they  should  remain  during  the  period 
of  hostilities.  If  possible,  there  should  be  some  provision  made  for  the  drain- 
age of  this  space.  In  the  vicinity  of  the  dressing  station  or  adjoining  it  there 
siiould  be  arranged  a  berthing  space  for  the  wounded  sufficient  to  accommodate 
about  10  per  cent  of  the  complement.  This  space  should  be  easy  of  access 
from  the  dressing  station,  and,  like  the  latter,  have  an  abundant  air  supply.  In 
addition  to  the  usual  equipment  transferred  from  the  sick  bay  and  operating 
room  and  distributed  in  the  dressing  stations  the  following  articles  should 
be  provided :  Electric  fans,  with  proper  connections ;  half  tubs ;  water  buckets ; 
swabs  and  brooms;  washing  stands;  tables  for  apparatus;  shelves;  supports 
or  hooks  for  irrigators,  etc.;  dressing  lockers;  bedding  for  the  berthing  space 
for  wounded;  restoratives,  etc.  A  reserve  supply  of  surgical  dressings  should 
be  available  on  this  deck  in  a  secondary  station,  behind  armor,  and  accessible 
for  distribution  to  the  dressing  stations,  if  required. 

(b)  The  station  of  the  medical  officer  of  the  ship  during  action  will,  as  a  rule, 
be  at  the  main  (operating)  dressing  station,  where  he  will  see  that  the  neces- 
sary equipment  is  provided. 

1825.  Preliminary  to  battle  the  personnel  should  be  required  to  bathe  and 
put  on  clean  underclothing. 

As  part  of  the  preparation  for  battle  it  is  recommended  that  socks,  drawers, 
and  undershirts  be  soaked  for  five  minutes  overnight  in  a  solution  of  ammonium 
phosphate,  made  by  dissolving  1  pound  of  ammonium  phosphate  (NH,)  J^PO*  in 
2  quarts  of  water,  which  reduces  inflammability.  When  large  quantities  of 
thi.s  solution  are  made  up  and  kept  for  future  use  and  many  garments  are  to 
be  soaked  in  it,  add  boric  acid,  1  ounce  to  each  2  quarts,  to  prevent  fermenta- 
tion. Except  in  the  most  risorous  weather,  the  uniform  for  action  should  be 
clean  white  (washable)  clothes.  When  whites  are  to  be  used,  they  also  can  be 
immersed  in  the  ammonium  phosphate  solution.      (See  par.  1003.) 

182«.  IVIeans  of  identification  of  the  dead,  as  reipiired  by  article  17  of  the 
Tenth  Hague  Convention,  should  be  provided  for  each  officer  and  man.  (See 
2097,  Identification  tag.)      (See  General  Order  No.  294.) 

1827.  The  organization  of  the  INIedical  Department,  showing  all  dispositions 
under  battle  conditions,  should  be  worked  out  for  the  ship  as  soon  after  going 
into  commission  as  practicable.  Provision  should  be  made  for  instruction 
of  officers  and  men  in  first-aid;  for  the  equipment  and  organization  of  battle 
dressing  stations,  as  described  above;  and  for  a  definite  organization  of  the 
personnel  of  these  stations,  as  well  as  for  their  progressive  instruction  in  fir.st- 


110        MANUAL  FOK  THE   MEDICAL  DEPAKTMENT,    U.    8.    NAVJi'. 

aid  aud  transijortation  methods.  During  action  the  difliculties  of  transporta- 
tion preclude  any  extensive  exercise  ol:  the  functions  of  the  stretcher  men. 
and  as  their  most  important  duties  are  to  be  performed  when  the  action  is  over, 
or  during  interval  of  action,  they  will  avoid  exposing  tliemselves  unnecessarily. 
Such  emergency  work  as  is  feasible  will  be  performed. 

182«.  Tlie  tiMlley  and  bakery  in  ships  of  old  type,  if  intact,  after  an  engage- 
ment'may  be  placed  at  the  disposition  of  the  medical  officer  for  preparing  addi- 
tional hot  water  and  dressings  and  for  sterilizing  instruments. 

1829.  Operating  room:  If  not  dismantled,  the  ship's  operating  room  may  be 
made  use  of  after  the  action  to  supplement  the  work  of  the  dressing  stations, 
provided  the  removal  of  the  gravely  wounded  direct  to  hospital  ships  is  not 

feasible.  .,,  ,  .  i    ,  ,     .,     ^,    u 

1830.  Transportation  of  wounded:  Apparatus  wdl  be  provided  by  tiie  Medi- 
cal Department  of  the  ship  for  transportation  of  wounded,  but  complicated 
appliances  liable  to  disablement  will  be  avoided.  Simple  measures  designeil 
to  facilitate  transporting  wounded  by  stretcher  directly  to  the  dressing  stations 
by  the  most  convenient  hatch,  down  which  they  will  be  lowered  or  passed 
by  hand  to  the  deck  below,  or  over  the  side  to  boats  from  the  hospital  ship,  are 
to  be  preferred  to  more  elaborate  means  of  transport. 

1831.  A  suitable  place  should  be  assigned  for  the  di-sposition  of  the  dead. 

1832.  When  the  medical  transport  or  hospital  ship  is  at  hand,  the  seriously 
wounded  should  be  transferred  as  promptly  as  is  consistent  with  their  welfare. 
A  fighting  ship  should  be  cleared  of  such  cases  as  soon  as  possible  after  an 
action,  in  order  that  she  may  be  ready  to  reengage  in  battle.  On  the  other 
hand,  patients  who  will  probably  soon  be  fit  for  duty  should  be  retained  on 
board,  aud  these  may  constitute  a  large  proportion  of  all  cases. 

Skction  3. — ^The  Landing  Force  fob  Expeditionaby  Sebvicb. 

(See  also,  The  Landing  Force  and  Small  Arm  Instructions;  Drill  Regulation? 
for  the  Hospital  Corps,  U.  S.  Navy;  Uuilorm  Regulations,  U.  S.  Navy,  1913; 
and  Sanitary  Directions  for  Landing  Parties,  ch.  14,  sec.  9.     See  Fleet  Regu- 

ISli.  The  organization  of  the  Medical  Department  for  duty  with  the  lauding 
force  will  depend  upon  the  size  and  character  of  the  expedition.  The  landing 
force  may  consist  of  a  battalion,  regiment,  or  a  brigade.  The  organization  of 
the  battle  tleet  into  four  divisions,  each  of  four  ships,  contemplates  the  landing 
force  of  a  division  (four  or  five  battalions,  including  the  marine  battalion)  as 
a  regiment,  and  the  total  force  of  the  tleet  (four  regiments)  as  a  brigade.  Two 
or  more  companies  form  a  battalion,  two  or  more  battalions  a  regiment,  and 
two  or  more  regiments  a  brigade. 

1842.  The  brigade  surgeon  will  serve  on  the  staff  of  the  brigade  commander. 
He  will  be  held  responsible  for  the  efliciency  of  his  department  and  from  time 
to  time  make  such  suggestions  and  recommendations  to  the  brigade  commander 
relative  to  the  same  as  the  exigencies  of  the  case  may  demand.  When  fur- 
nished with  information  regarding  the  military  situation,  it  shall  be  his  duty 
to  study  it  and  to  take  the  initiative  in  preparing  for  and  anticipating  demands 
and  eniergencies  in  his  department.  He  shall  act  upon  his  own  responsibility 
when  necessary  to  do  so.  reporting  his  action  to  the  brigade  commander  for  his 
approval,  lie  shall  submit  plans  bel'orehand  whenever  practicable.  He  shall 
keep  records  and  notes  of  all  events  and  matters  of  importance  in  conne<-tion 
with  his  duties,  and  to  assist  him  in  this  duty  he  will  have  detailed  as  n 
memi)er  of  the  noncommis-sioued  stalf  a  chief  petty  officer  (chief  pharmacists 
mate)  or  a  pharmacist. 

The  brigade  surgeon  shall  have  giMieral  direction  of  all  divisions  of  the  sani- 
tary personnel ;  the  organ  zaiion  el"  the  transiiort  column  and  the  reserve  n)e<li- 
cal  supplv;  evacuation  of  siek  and  wounded  to  the  rear;  and  the  organization 
of  such  ifeld  or  base  hospitals  :is  t!:o  exigencies  of  the  service  may  demand. 

1813.  The  regimental  surgeon  is  selected  by  the  regimental  commander  from 
the  list  of  senior  surgeons  of  the  ships  of  the  division. 


MANUAL  FOR   THE   MEDICAL   DEPARTMEKT,   U.    S.    NAVV.        HI 

The  regimental  surgeou  shall  prepare  lor  the  regimental  commauiler  of  land- 
ing parlies  such  sanitary,  hygienic,  and  hospital  regulations  as  may  be  required, 
and  shall  submit  such  recommendations  as  he  may  deem  necesary  for  the  preser- 
vation of  the  health  of  the  command.  Whenever  practicable  such  regulations 
and  recommendations  shall  be  submitted  to  the  brigade  surgeon  for  prior 
approval.  He  shall  advise  the  regimental  commander  regarding  tlie  organiza- 
tion aud  equipment  of  the  ambulance  parties  of  the  several  battalions,  and  shall 
submit  regulations  for  the  Instruction  in  lirst  aid  of  the  wounded  and  for  the 
practical  drill  of  stretcher  men.  He  shall,  if  necessary,  establish  and  assume 
general  charge  of  the  regimental  aid  station,  and  shall  make  all  arrangements 
for  the  transport  of  sick  and  for  forwarding  cases  to  the  rear  for  treatment. 
He  shall  inspect  and  as.sume  general  charge  of  the  ambulance  parties  when- 
ever the  latter  are  massed  by  direction  of  the  regimental  commander.  He  will 
prescribe  the  medical  and  surgical  outfits  to  be  landed  in  any  case,  regarding 
which  he  will  advise  the  battalion  surgeons,  and  report  regarding  the  number  of 
mounts  and  the  transportation  required  for  the  medical  personnel  and  material. 

1844.  The  battalion  surgeon  shall  be  held  responsible  for  the  efficiency  of 
his  department,  and  shall  make  such  suggestions  and  recommendations  to'  the 
battalion  commander  and  keep  such  records  as  the  exigencies  of  the  service 
may  demand.  He  shall  take  the  initiative  in  providing  for  all  details  to  meet 
the  emergencies  of  the  service. 

The  battalion  surgeon  shall  organize  and  instruct  the  ambulance  party  as 
directed  by  the  battalion  commander.  He  shall  establish  an  aid  station  and 
assist  the  regimental  surgeon  in  carrying  out  the  general  regulations  for  the 
care  of  the  sick  and  wounded  and  for  the  preservation  of  health.  He  will  pre- 
scribe, under  the  direction  of  the  regimental  surgeon,  the  necessary  medical 
and  surgical  outfits,  see  that  first-aid  packages  are  distributed,  and  report  to 
the  regimental  surgeon,  through  ofiicial  channels,  regarding  the  number  of 
mounts  and  the  transportation  required.  He  shall  assure  himself  that  none  of 
the  personnel  to  be  landed  is  suffering  from  active  venereal  diease,  infectious 
or  contagious  disease,  and  that  all  have  had  protective  inoculations  and 
vaccinations  against  typhoid  fever  and  smallpox.  Conditions  of  the  feet  inter- 
fering materially  with  marching  should  determine  a  man's  rejection  for  active 
and  distant  service  ashore. 

1845.  The  ambulance  party  of  each  battalion  will  be  composed  ordinarily  of 
one  stretcher  man  for  each  section  (two  sections  to  a  company),  with  a  chief 
pharmacist's  mate  and  as  many  Hospital  Corpsmen  as  the  circumstances  may  de- 
mand. One  stretcher  will  be  provided  for  each  pair  of  stretcher  men.  Stretcher 
men  will  be  a  permanent  detail,  in  order  that  their  instruction  may  be  progres- 
sive, and  they  will  not  be  detailed  from  the  engineer  force  unless  unavoidable. 
(Atlantic  Fleet  Regulations,  1913,  par.  208  (6).)  The  necessary  medical  aud 
surgical  outfits  will  be  prescribed  my  the  surgeon.  The  ambulance  party  will 
ordinarily  carry  no  weapons  but  may  be  armed  if  necessary  for  its  own  defense 
or  for  that  of  the  sick  or  woimded  or  be  provided  with  an  armed  escort,  fur- 
nished with  authority  in  due  form,  and  will  wear  the  Geneva  cross  (brassard) 
on  the  left  arm.  An  armed  escort  or  guard  will  be  provided  with  a  certificate  of 
identity.  The  distinctive  Red  Cross  flag  will  be  displayed  over  sanitary  forma- 
tions and  establishments.  Against  a  savage  or  uncivilized  enemy,  however,  the 
men  of  the  hospital  staff  and  ambulance  party  will  always  be  armed.  (Art.  S, 
Geneva  Convention.)  Surgeons  will  wear  swords  only  at  parades,  ceremonies, 
and  on  other  occasions  when  prescribed.  On  active  service  and  at  practical 
exercises  with  the  landing  force  they  will  be  guided  by  orders  issued  governing 
uniform,  etc.,  or  ob.serve  the  rule  of  the  hospital  staff.  ,     .,     ,, 

1846.  The  special  equipment  of  the  ambulance  party  is  as  follows: 

(a)  One  litter  for  each  two  stretcher  meUf,  ,;,,,,  ,, ,  ,, 

(b)  Brassard  on  each  arm  for  each  man.  ".'.,',;  _    '   ',  . 

(c)  Hospital  Corps  pouch  for  each  Hospital 'dorpsman( large  for  chief,  phar- 
macist's mate;  small  for  others). 

(d)  Hospital  Corps  flag  for  each  detachment.  (If  acting  singly  the  national 
flag  will  be  displayed  -with  the  Red  Cross  flasr.) 


112         MANUAL   FOR    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY. 

1847.  (a)  Naval  oftieors  and  men  serving  witli  an  expeflilionnry  force  of 
marines  niny  wear  the  field  uniform  prescribed  for  officers  and  enlisted  men  of 
the  Marine  Corps,  respectively,  suhstitntins  naval  insiamia  for  those  of  the 
Marine  Corps.  (Art.  .^5  (ft)  ;  Uniform  Rotiulations.  191R.)  The  following 
allowance  of  basiKatre  is  prescribed  for  officers  ordered  on  expeditionary  duty 
with  laarines:  All  ollicers— bedding  and  clothing  roll  (motmted  oflicei's,  in  addi- 
tion, horse  equiimient)  ;  field  olTicers — two  steamer  trunks.  No  trunk  shall  be 
taken  whose  cubic  <'ontents  is  more  than  5  f^et.  Officers  will  provide  them- 
selves with  the  standard  Army  trunk,  dimensions  31  by  17  by  14  inches.  (Head- 
quarters, U.  S.  Marine  Corps.  Aug.  9,  191.^.) 

(6)  Men  of  the  Navy  Hospital  Corps  are  entitled  to  an  initial  gratuitous  issue 
of  clothing  when  ordered  to  expeditionary  service,  to  consist  of  the  following 
articles,  viz : 

1  hat,  field.  1  belt,  trousers,   web. 

2  shirts,  flannel.  1  shoes,   russet,  pair. 
2  trousers,  field.                                    1  leggings,  pair. 

The  issue  of  the  above  articles  in  the  quantities  prescribed  is  a  proper  charge 
against  the  appropriation  "Contingent,  Navy,"  and  the  appropriation  "  Mainte- 
nance, Quartermaster's  Department,  Marine  Corps,"  will  be  reimbursed  for  all 
issues  made  as  gratuitous. 

Upon  the  receipt  of  an  approved  requisition  from  a  man  of  the  Navy  Hospital 
Corps,  ordered  to  duty  with  a  marine  expeditionary  force,  such  requisition  bear- 
ing the  approval  of  tiie  chief  .surgeon,  the  quartermaster  of  the  organization  to 
which  the  man  is  attached  vrill  issue  the  clothing.  (System  of  Accountability, 
U.  S.  M.  C,  par.  244.) 

Two  rating  badges  (special)  are  issued  with  the  above  outfit. 

1848.  The  Landing  Force  and  Small  Arms  Instructions  provides  that  during 
an  engagement  additional  reinforcements  of  stretcher  men  may  be  detailed  from 
pioneers,  signalmen,  and  others. 

1849.  A  hospital  ship  or  ships  will  be  used  as  a  base  hospital  whenever 
in-acticable,  and  the  sick  and  wounded  will  be  seut  on  board  as  promptly  as  pos- 
sible in  order  to  relieve  th(>  sanitary  force  and  to  avoid  hampering  the  move- 
ments of  the  landing  force.  In  case  a  base  hospital  is  established  on  shore  it 
will  be  under  charge  of  a  medical  officer  detailed  for  that  purpose  who  will  co- 
operate with  the  brigade  surgeon.  The  in.1ured  will  remain  in  the  base  hospital 
until  they  are  fit  for  duty  or  able  to  be  sent  to  a  home  station. 

185().  Distant  service:  Special  provisions  nnist  be  made  for  transport  of  the 
sick  and  wounded  in  the  case  of  distant  expeditions  and  long  marches.  Requi- 
sitions .should  be  made  upon  the  regijuental  quartermaster  (or  upon  commis- 
saries in  case  of  battalions  acting  alone)  for  necessary  tran.sportation  of  the 
medifal  material  and  personnel,  including  the  disabled. 

1851.  As  provided  under  article  4,  (Jeneva  Convention  of  1906,  and  article  17 
of  the  Tenth  Ilsigue  Convention  of  1907,  all  personnel  .should  carry  an  appro- 
priate id(>ntification  mark  or  tag. 

185'i.  I>oose  leaves  from  health  records  and  Form  F  (cards)  will  ordinarily 
he  the  only  material  landed  with  expeditionary  forces  for  keeping  medical 
i-ecords.  medical  histories  being  entered  thereon  and  inserted  in  health  record 
.It  a  later  date  or  upon  return  to  the  ship. 

1853.  I'^ast  pulling  boats  or  steam  launches  containing  the  medicMl  officers 
with  assistants  and  pro])er  outfits,  will  be  stationed  in  rear  of  the  main  line  at 
the  end  of  the  t<>w.  They  will  be  desigiuited  by  the  hospital  flag  placed  in  the 
bow  of  the  boat.  ,  ,   ,  ; 

1854.  Parades,  reviews,  drills:  PpSi$  of  orflc^t^. 

(a)  IN'gimental  staff  (including  regimental  surgeon).  In  all  formations  the 
staff  and  aids  are  3  paces  in  rear  of  the  regimental  commander,  the  r(»gimental 
adjutant  on  the  right,  the  other  staff  oilicers  and  aids  in  order  of  rank,  the  senior 


MANUAL   for' THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.        113 

on  the  right ;  but  if  only  one  staff  officer  is  present  he  takes  post  3  paces  to  the 
rear  and  1  pace  to  the  right  of  the  regimental  commander. 

(b)  Battalion  staff  (including  battalion  surgeon).  The  staff  officers,  except 
the  adjutant,  in  order  of  rank,  the  senior  on  the  right,  take  post  1  pace  apart, 
3  paces  to  the  rear  of  the  battalion  commander. 

(c)  The  staff  of  the  reviewing  officer  is  in  single  rank,  6  paces  in  the  rear  of 
him,  the  senior  to  the  right. 

id)  When  passing  in  review  the  staff  of  each  commander  salutes  and  returns 
to  the  carry  with  him. 

When  landing  for  parades  or  reviews  ambulance  parties  will  not  be  massed, 
but  each  will  follow  its  own  battalion,  each  stretcher  being  carried  by  four 
stretcher  men,  the  stretchers  being  horizontal  and  carried  abreast  of  each  other. 
In  all  other  cases  the  special  detail  will  be  massed  by  regiments,  and  for  actual 
service  or  for  drills  other  than  parades  there  will  be  one  stretcher  for  each  two 
stretcher  men.     (Atlantic  Fleet  Regulations,  1913,  pai-.  208  a.) 

On  parades  the  ambulance  party  will  be  landed  not  simply  for  parade  but  to 
administer  first-aid  and  handle  cases  of  sunstroke  or  accident.  (Atlantic  Fleet 
Regulations,  1913,  208  b.) 

Section  4. — Outline  of  the  Organization  of  the  Medical  Depabtment  in 

THE  Field. 

1861.  The  functions  of  the  Medical  Department  in  the  field  fall  under  the 
following  headings:  (a)  Sanitation;  (b)  professional  care  and  treatment  of 
sick  and  wounded;  (c)  providing  medical  and  hospital  supplies;  (d)  collection 
and  evacuation  of  sick  and  wounded. 

1862.  Assistance  will  usually  be  rendered  to  the  wounded  at  the  following 
points:  (a)  The  regimental  aid  station;  (5)  the  dressing  station;  (c)  the  bri- 
gade hospital;  (d)  the  base  hospital  (hospital  ship  or  other  ship). 

1863.  At  the  beginning  of  an  engagement  the  wounded  are  cared  for  by  the 
regimental  ambulance  party.  Those  able  to  walk  are  taken  to  sheltered  places 
as  soon  as  possible,  out  of  the  way  of  advancing  troops. 

If  the  size  of  the  regimental  ambulance  party  permit,  the  force  at  each  regi- 
mental aid  station  (a)  may  v.'ith  propriety  be  divided  or  disposed  so  as  to 
handle  the  slightly  wounded  separately.  Their  presence  in  considerable  num- 
bers interferes  with  the  treatment  of  serious  cases  and  they  require  only  an 
application  or  readjustment  of  a  first-aid  bandage  before  being  ordered  back  to 
their  post  of  duty. 

1864.  Regimental  aid  stations  are  established  under  shelter  by  the  regi- 
mental surgeons  as  near  the  firing  line  as  possible.  If  the  enemy's  fire  is  such 
that  the  wounded  can  not  reach  the  station,  advantage  is  taken  of  the  char- 
acter of  the  terrain  affording  temporary  shelter,  and  the  wounded  are  brought 
in  during  lulls  in  firing  or  after  nightfall.  At  this  station  the  Hospital  Corps- 
men  shah  be  prepared  to  apply  tourniquets,  adjust  temporary  splints,  apply  pro- 
tective dressings,  and  administer  stimulants.  They  should  carry  knives  or 
heavy  bandage  shears  for  cutting  away  clothing  in  addition  to  the  usual  equip- 
ment contained  in  the  Hospital  Corps  pouch.  The  wounded  who  are  able  to 
walk  will,  after  the  application  of  a  simple  protective  dressing,  be  marched  to 
the  dressing  station  or,  in  the  case  of  trivial  wounds,  be  directed  to  resume 
their  posts  on  the  firing  line.  The  wounded  who  are  unable  to  walk  will  be 
carried  from  the  aid  station  to  the  dressing  station  (or  direct  to  the  field 
hospital). 

1865.  The  brigade  dressing  station  is  the  assembling  point  for  the  woundetl 
from  the  regimental  aid  stations.  It  will  be  located  at  some  point  protected 
from  rifle  and  artillery  fire,  accessible  to  the  aid  stations,  and  at  a  point  that 
can  be  reached  by  ambulance  or  other  transportation.  A  water  supply  and 
firewood  or  other  fuel  are  desirable  features  at  this  point. 

98601°— 17 8 


114        MANUAL   ror.    THE   MEDICAL   DEPABTMENT^   U.    rf.    XAVY. 

The  dressing  station  will  be  designated  by  a  Red  Cross  flag'  by  day  and  will 
hoist  a  white  over  green  light  at  night.  At  this  station  all  dressings  will  he  care- 
fully examined,  bnt  not  renewed  unless  absolutely  necessary.  Tourniquets  will 
be  removed  and  bleeding  vessels  tied,  splints  readjusted,  and  the  wounded  classi- 
fied and  tagged.  Examination  of  wounds  .shall  be  restricted  as  much  as  ncs- 
sible,  and  the  cleaning  of  the  wound  and  surrounding  skin  limited  to  whar 
is  absolutely  essential.  Water,  food,  and  stimulants  will  be  .served  out  as  re- 
quired. After  inspection,  treatment,  and  classification  of  the  wounded  the\ 
will  bo  transported  to  the  rear  as  soon  as  possible. 

1860.  The  aid  and  dressing  stations  are  of  necessity  of  a  temporary  cliur- 
acter,  and  should  be  kept  as  mobile  as  the  character  of  the  work  at  hand  will 
permit. 

1867.  If  the  landing  force  is  on  distant  service  a  field  hospital  may  be  neces- 
sary. This  hospital  should  be  located  beyond  the  zone  of  conflict,  usually  3  or 
4  niiles  in  rear  of  the  dre.ssing  station. 

1868.  The  brigade  hospital  receives  the  wounded  from  dressing  stations  and 
retains  them  for  treatment  only  so  long  as  may  be  necessary  to  arrange  for 
their  further  transportation  to  the  rear  (base  hospital). 

Only  urgently  necessary  operations  will  be  performed  at  this  point,  and  the 
brigade  hospital  should  be  promptly  cleared  of  all  wounded  as  soon  as  their 
condition  permits  of  transportation.  The  brigade  hospital  will  fly  ;i  Red  Cross 
flag  by  day  and  will  hoist  a  green  over  a  white  light  at  night. 

i860.  The  base  hospital  will  be  established  at  the  advance  naval  base.  This 
hospital  may  not  be  needed,  or  needed  only  as  a  receiving  station,  or  convales- 
cent camp  or  reserve  hospital,  if  a  hospital  ship  is  available. 

^The  flag  of  the  Geneva  Convention  for  us<;  at  a  dressinjr  station  has  the  followintr 
dimensions.  White  biintinjr,  I'S  by  16  inches,  witli  a  red  cross  of  bunting  12  inches  high 
and  12  inches  wide  iv  the  center,  arms  of  cross  to  be  4  inches  wide.  For  a  brigade  hos- 
pital, 6  by  4  feet,  with  a  red  cross  of  bunting  3  feet  high  and  3  feet  wide  in  the  center, 
arms  of  cross  to  be  12  inches  wide. 


MANUAL    F0>:    THE   MEDICAL    DEPARTMENT,    U.    S.    NAVY.         115 


Section  5. — DiAGiiA^r. 
Naval    Brigade. 


]^J' Regiment. 


^."-^  Regiment.  3^^  Regiment. 

— 1  I  


ifh 


4T  Regiment 


I ines  of  assistance  for 
Landing  force. 


A.  Regimental  aid  stations :  Here  skulkers  should  be  checked  and  effectives  separated  from 

noneffectives. 

B.  Brigade  dressing  station  :  Not  necessary  when  a  regiment  is  acting  singly.     Here  cases 

are  assembled  from  the  whole  brigade  for  classification  and  transport  to  rear. 

C.  Brigade  hospital :   Not  necessary  if  operating  near  base.     Located  3  to  4  miles  in  rear 

of  dressing  station,  out  of  range  of  weapons. 

D.  Base  hospital :  Not  necessary  tf  a  hospital  ship  is  used  as  base  hospital. 


CHAPTER  11. 


PHYSICAL  EXAMINATION  OF  CANDIDATES  FOR  ADMISSION,  APPOINT- 
MENT, OR  PROMOTION  AS  COMMISSIONED  AND  COMMISSIONED 
WARRANT  OFFICERS  OF  THE  NAVY  AND  MARINE  CORPS. 

Section  1. — Laws  Relating  to  Physical  Examination  fob  Appointment  and 

Promotion  of  Officers. 

1901.  Officers  of  vessels  shall  be  citizens.    Sec.  1428,  R.  S. 

1902.  Officers  appointed  by  President,  by  and  with  advice  and  consent  of  the 
Senate.     Sees.  1369,  1378,  1400,  1402,  R.  S. 

1903.  Appointments  of  assistant  surgeons  and  acting  assistant  surgeons. 
(See  under  "Medical  Corps,"  ch.  2.) 

1904.  Assistant  paymaster.     Sec.  1379,  R.  S. 

1905.  Chaplain.     Sec.  1395,  R.  S. 

1906.  Professor  of  mathematics.    Sec.  1400,  R.  S. ;  act  January  20,  1881. 

1907.  Naval  constructors.     Sec.  1402.  R.  S. 

1908.  Marine  Corps,  appointment.  Sec.  1599,  R.  S. ;  acts  Augu.st  5,  1882, 
March  3,  1899,  March  3,  1901,  March  3,  1903. 

1909.  Officers  not  promoted  to  be  retired.    Sec.  1447,  R.  S. 

1910.  No  officer  promoted  unless  physically  qualified  for  all  his  duties  at  sea. 
Sec.  1493,  R.  S. 

1911.  Wounds  in  line  of  duty  do  not  necessarily  disqualify  for  promotion. 
Sec.  1494.  R.  S. 

1912.  Officer  failing  physically  from  disability  in  line  of  duty  entitled  to 
retire  with  rank  to  which  his  seniority  would  entitle  him  to  be  promoted.  Act 
March  4,  1911. 

1913.  Physical  examination  of  officers  of  the  Naval  Militia  upon  muster  into 
service  of  tlie  United  States.    Act  of  February  16,  1914. 

Section  2. — Navy  Regulations  and  Naval  Instructions  Relating  to  Physical 
Examination  of  Officers  for  Admission  and  Promotion. 

1921.  Bureau  of  Medicine  and  Surgery  to  provide  for  physical  examinations. 

R  133  (1). 

1922.  Physical  examination  for  Medical  Reserve  Corps.    R  2982. 

1923.  Physical  examination  for  Dental  Corps.     R  2989. 

1924.  Appointment  subject  to  (physical)  examination.     R  3301  (1). 

1925.  Physical  examination  to  precede  mental  and  professional  and  examina- 
tion to  terminate  if  physically  unfit.     (R  331  (2).)     R  3301  (2). 

192(>.  Physical  qualifications  of  candidates  for  assistant  paymaster.  (R 
332  (2).)     R  3306  (1).  ' 

1927.  Physical  examination  for  assistant  payrilaster.     R  3306  (2). 

1928.  Physical  examination  for  assistant  surgeon.     R  3305  (1). 

1929.  Physical  examination  for  acting  assistant  surgeon.    R  3305  (2). 

1930.  Physical  examination  for  chaplain.    R  3307  (2). 

1931.  Physical  examination  for  assistant  civil  engineer.     R  3309. 

1932.  Physical  exaiuination  for  machinist.    R  3315  (3). 

117 


118        MANUAL  FOE   THE    MliDICAL   DEPARTMENT,   U.    S.    NAVY. 

1934.  riiysical  examination  for  nurses.    11  3.'>22  (2).     • 

1935.  I'liysical  examination  for  paymaster's  clerk,  Marine  Corps.    RH42  '.3>. 
1{)3(».   riiysical  examination  required  on  promotionln  Navy.    II  3331. 

1937.  PliVsical  examination  for  promotion  in  Marine  Corps.  (I  3662  lo 
3671)  R  3332  (2). 

1938.  Health  record  on  pliysical  examination.     I  708;  I  32.57. 

1939.  An  ollicer  due  for  promotion  may  be  examined  on  a  foreign  station. 
R  3333.  _fr      •    '  i 

l;»i().   IMiysical  examination  precedes  professional.    R  331    (2). 

1911.   Oilicer  failin;,'  pliysically  may  be  retired  in  next  raiiii.     R  331  (3). 

191*2.   Procedure  svlien  ollicer  is  rejected  physically  for  promotion.    R  331  (4). 

19-13.  'i'\phoid  iirophylattic  to  he  administered  to  all  persoas  upon  their  first 
entry  into  the  naval  service.     I  3212. 

1914.  Kxaminins  boards  for  ihe  Medical  Corps  to  forward  merit  roll  of 
candidates  for  admission  or  promotion  direct  to  bureau  semiannually  on  Janu- 
ary 1  and  July  1.     I  5247  (9).  .;;  ^.uj.A     .1 

Section  3. — Instbuctions  Relating  to  Such  Examinations. 

1951.  All  candidates  for  appointment  as  commissioned  oliicers  in  the  Navy 
or  Marine  Coriis  from  civil  life  and  all  officers  preliminary  to  promotion  must 
be  physically  examined  by  a  board  of  officers,  including  naval  surgeons.  Candi- 
dates for  admission  to  or  promotion  in  the  Medical  Corps  are  examined  by  a 
board  of  medical  officers.  The  physical  examination  will  precede  the  mental 
and  professional. 

1952.  In  comluctirg  the  physical  examination  for  such  appointments  the 
board  of  medical  officers  designated  for  this  purpose  shall  be  governed  s\ib- 
.stautially  by  the  instructions  contained  in  the  Navy  Regulations  relating  to  the 
physical   examination  of  recruits.     (.See  ch.   12.) 

1953.  The  board  shall  exercLse  the  greatest  care  in  the  performance  of  tliis 
duty,  and  in  the  interest  of  efficiency  a  high  standard  of  physical  requirements 
should  be  maintained. 

1954.  The  examination  in  each  case  must  be  complete<l  according  to  the 
official  forms,  and  under  no  circumstances  shall  it  be  suspended  on  the  recogni- 
tion of  a  disqualifying  defect. 

1955.  The  Imanl  is  lurlher  required  to  make  a  careful  urinary  analysis  in 
the  case  of  every  candidate  undergoing  examination  for  appointment  or  promo- 
tion. Tlie  urine  .sliould  be  tested  qualitatively,  and  (if  deemed  necessary) 
quantitatively  for  sugar  and  albumin.  In  every  ca.se  where  albumin  exisis  in 
appreciable  (piantity  a  micro.scopic  examination  of  the  urine  shall  be  made. 

1956.  In  every  ca.se  in  which  the  physical  condition  of  the  candidate  shows  a 
marked  deviation  from  the  usual  standards  of  lieight  and  weight,  or  where  there 
exists  marked  cachexia  or  any  evidences  of  constitutional  weakness,  he  shall  be 
rejected. 

1957.  FA-cry  applicant  must  have  at  least  20  sound  teeth,. and  of  these  not 
less  than  four  f.ppo^ed  incisors  and  four  opposed  molars.  Upon  promotion  de- 
fective teeth  alone  do  not  cause  rejection.  Teeth  properly  filled  shall  noi  be 
considered  unsound. 

195M.  A  can<lidate  for  admission  mu.st  declare  under  oath  that  he  labors 
miller  no  niputnl  or  conslitutioniil  disease  or  weakness  or  any  other  inqierfec- 
tion  or  disability  that  may  Interfere  with  the  most  efficient  discharge  of  the 
duties  of  an  oflicer  in  any  climate.  An  officer  for  promotiou  makes  a  similar 
st;iteuient,  but  this  is  not  required  to  be  sworn. 

1959,  In  the  ca.se  of  oIlictTs  for  promotion  the  vision  and  hearing  and  the 
funrtions  of  all  the  other  organs  of  the  body  must  be  such  as  in  the  opinion  and 
judgment  of  the  hoard  will  enable  the  officers  undergoing  exiniination  t«>  lu-r- 
form  efficiently  all  of  their  duties  at  sea. 

Ttl 


MANUAL  FOR   THE   MEDICAL   DEPARTMENT,   U.   S.    NAVY.        119 

1960.  In  the  Medical  Reserve  Corps  and  the  Dental  Reserve  Corps  for  acti\e 
service  only  in  time  of  emergency  the  physical  qualifications  for  candidates 
shall  conform  in  general  to  those  for  the  other  corps  of  the  Navy. 

1901.  Any  one  of  the  following  conditions  will  be  sufficient  to  cause  the 
rejection  of  a  candidate  for  admission : 

(a)  Feeble  constitution,  poor  physique,  impaired  general  health. 

(b)  Any  disease  or  deformity,  either  congenital  or  acquired,  which  would  im- 
pair efficiency,  such  as  weak  or  deranged  intellect,  cutaneous  disease,  parasites 
of  the  skin  or  its  appendages,  deformity  of  the  skull,  abnormal  curvature  of  the 
spine,  torticollis,  inefficiency  of  joints  or  limbs,  deformity  of  joints  or  bones, 
either  congenital  or  the  result  of  disease  or  injury,  epilepsy,  or  other  convul- 
sions, diseases  of  the  eye,  defective  vision,  color  blindness,  impaired  hearing  or 
disease  of  the  ear,  chronic  nasal  catarrh,  ozena,  polypi,  great  enlargement  of  the 
tonsils,  impediment  of  speech,  disease  of  heart  or  lungs,  enlarged  abdominal 
organs,  evidence  of  sclerosis,  tumors,  hernia,  undescended  testicle,  large  varico- 
cele, sarcocele,  hydrocele,  stricture,  fistula,  hemorrhoids,  varicose  veins,  disease 
of  the  genito-urinary  organs,  diseased  or  deformed  feet,  evidences  of  intemperance 
or  of  the  morbid  use  of  drugs  loss  of  many  teeth  or  teeth  generally  unsound 
(teeth  properly  filled  are  not  to  be  considered  unsound).  ,    ,. 

(c)  Anyacutedisea.se.  '    - 
1962.  For  any  corps  the  height  must  not  be  less  than  5  feet  6  inches  stripped. 

Table  of  physical  proportion.^  for  height,  weight,  and,  chest  mea-rurements. 


Height. 

Weight. 

Chest 
(mean  cir- 
cumfer- 
ence). 

Chest 
(mean  cir- 
cumfer- 
ence). 

Height. 

Weight. 

Inches. 
66 
67 
68 
69 

Pounds. 
132 
134 
141 
148 

Inches. 
33i 
34 
Mi 
345 

Inches. 
70 
71 
72 
73 

Pounds. 

lO.") 

162 
169 
176 

Inches. 
35J 
3G 
36i 
36J 

It  is  not  necessary  that  the  applicant  should  conform  exactly  to  the  figures  In 
the  foregoing  table,  which  is  given  to  show  what  is  regarded  as  a  fair  standard 
of  physical  proportions.  A  variation  not  exceeding  15  pounds  in  weight  or  1 
inch  in  the  mean  chest  measurement  below  the  standard  given  in  the  table  is 
admissible  when  the  candidate  is  active,  has  firm  muscles,  and  is  evidently  vig- 
orous and  healthy.  A  chest  expansion  of  less  than  2  J  inches  is  a  sufficient  cause 
for  rejection  of  the  applicant. 

1963.  Color  perception  must  be  normal  and  acuteness  of  vision  upon  a(hnis- 
sion  or  appointment  must  be  as  follows : 

For  the  Medical  Corps,  Dental  Corps,  civil  engineers,  and  for  chaplains,  not 
less  than  12/20  for  each  eye,  xinaided  by  glasses,  and  capable  of  correction  by 
glasses  to  20/20. 

For  line  officers  and  the  Pay  Corps,  not  less  than  15/20  for  each  eye,  unaided 
by  glasses,  and  capable  of  correction  by  glasses  to  20/20. 

For  the  Marine  Corps,  18/20  for  each  eye,  unaided  by  glasses,  and  capable  of 
correction  by  glasses  to  20/20. 

1964.  The  hearing  of  the  candidate  must  be  normal  (40/40  inches  i>y  watch 
and  15/15  feet  by  voice)  for  each  ear.  In  the  case  of  promotion  of  officers  the 
nature  of  the  duties  of  the  candidate  should  be  considered,  but,  as  a  rule,  less, 
than  7/15  hearing  in  either  ear  is  a  disqualifying  defect. 


120        MANUAL   FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

•    1066.  Canditlates  for  appointment  must  he  ))etwepn  llie  following  aues: 
Corps:  Years  of  a^. 

Acting  ensign  for  engineering  duty  only ^20  to  26 

Flying  Corps,  acting  ensign ^18  to  24  , 

Flying  Corps,  student  flyer 17t»21 

Niivai  Reserve  Force,  assistajit  surgeon,  for  sul)s('iiuent  app<nnt- 

ment  as  assistant  surgeon,  Medical  Corps . *  21  to  32 

*";'     Naval  Reserve  Force,  assistant  surgeon 21  to  44 

Dental  Corps,  dental  surgeon 24  to  ;J0 

Naval  Reserve  Force,  assistant  dental  surgeon 21  to  44 

Dental  Reserve  Corps,  dental  surgeon 22  to  45 

Pay  Corps,  assistant  paymaster =21to2<) 

Chaplain -1  to  31A 

,AIarine  Corps,  second  lieutenant  (enlisted  can<lidates) 21  to 27 

Marine  Corps,  second  lieutenant  (candidates  from  civil  life) 20  to  25 

Marine  Corps,  acting  second  lieutenant,  for  aeronautic  duty  only-  *  18  to  24 

l!)66.  Medical  officers  are  required  by  act  of  February  16,  1914,  to  cotuluet 
a  physical  examination  of  officers  of  the  Naval  Militia  when  mustered  into 
service  of  the  United  States.     (Gen.  Ord.  No.  150.) 

Skction  4. — Laws  Relating  to  the  Physical  Examination  of  Canuiuates  fob 
Admission  into  the  United  States  Naval  Academy. 

1971.  Examination  of  candidates.     Sec.  1515,  R.  S. 

1972.  Second  recommendation.     Sec.  1516,  R.  S. 

1973.  Qualification.?.     Sec.  1517,  R.  S. 

1974.  Ages  of  candidates  after  .January  1,  1904.  Act  March  3,  1903,  amend- 
ing section  1517,  R.  S. 

Section  5. — Regulations  Governing  the  Admission  of  Candidates  into  the 

Naval  Academy. 

1981.  Candidates  are  required  to  be  of  good  moral  character,  physically 
sound,  well  formed,  and  of  robust  constitution. 

Any  one  of  the  following  conditions  will  be  sufficient  to  cause  the  rejection 
of  a  candidate,  viz: 

(a)  Feeble  constitution,  inherited  or  acquired. 

(b)  Retarded  development. 

(c)  Impaired  general  health. 

id)  Decided  cachexia,  diathesis,  or  predisposition;  anemia,  from  malaria 
or  from  intestinal  parasites,  as  hookworm. 

(e)  Any  disease,  deformity,  or  result  of  injury  that  would  impair  efficiency; 
such  as — 

(cu)   Weak  or  disordered  intellect. 

(eb)  Cutaneous  or  communicable  disease. 

(ec)  Unnatural  curvature  of  the  spine,  torticollis,  or  other  deformity. 

{<'(!)  Inefficiency  of  either  of  the  extremities  or  large  articulations  froiu  any 
cau.se. 

(f:f)  Epilepsy  or  other  convulsions  within  five  years. 

(/)  Impaired  vision,  disease  of  the  organs  of  vision,  imperfect  color  sense; 
visuitl  (irntcneKS  must  he  normal,  i.  c,  20/20  for  each  eye  uithoiit  the  aid  of 
glasses.    There;  shall  be  no  deviation  from  this  standard. 

«  Additional  physical  qualifications  are  reguircd  of  candidates  for  aeronautic  duty    (see 

-Thi>  candidato  must  ho  under  ."^2  years  of  age  when  he  completes  the  cotirse  of  Instrnc- 
ilon  at  the  Naval  Medical  School,  and  is  further  examined  to  determine  fitness  for  com- 
misHlon  In  the  Medical  Corps. 

•Trhis  limitation  as  to  ape  does  not  apply  to  chief  pay  clerks  and  pay  clerks,  appointed 
us  Kuch  under  the  provisions  of  an  act  of  Consress  approved  March  .•?,  ini.">.  who  must 
be  between  the  ages  of  21  and  ^5  vears  at  the  time  of  appointment  as  assistant  paymaster. 


MANUAL  FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        121 

(g)  Impaired  hearing  or  disease  of  either  ear.  The  organs  of  hearing,  both 
the  conductive  apparatus  (outer  and  middle  ear)  and  the  percipient  app;fratus 
(internal  ear),  must  be  free  from  disease.  In  testing  tlie  liearing  of  the  can- 
didate, the  voice,  the  ticliing  of  a  watch,  and,  if  practicable,  Politzer's  acoume- 
ter  shall  be  employed. 

The  voice  is  a  more  reliable  method  of  determining  the  acuteness  of  hearing 
than  the  ticking  of  an  ordinary  watch,  as  it  allows  for  variations  in  hearing, 
with  the  modifications  produced  by  changes  in  pitch  and  tone.  Hearing  in 
each  ear  must  be  normally  acute  to  the  spoken  and  whispered  voice.  In  ex- 
amining the  acuteness  of  the  hearing  with  the  voice,  one  ear  of  the  candidate 
should  be  closed  while  the  other  ear  is  being  examined,  and  his  eyes  should  be 
covered  to  prevent  lip  reading.  The  ticking  of  an  ordinary  watch  should  be 
heard  a  distance  of  40  inches. 

(h)  Chronic  nasal  catarrh,  ozena,  polypi,  or  great  enlargement  of  the  tonsils. 

(i)  Impediment  of  speech  to  such  an  extent  as  to  impair  efficiency  in  the 
performance  of  duty. 

{k)  Disease  of  heart  or  lungs  or  decided  indications  of  liability  to  cardiac 
or  pulmonary  affections. 

(I)   Hernia,  complete  or  incomplete,  and  undescended  testis. 

(w)  Varicocele,  sarcocele,  hydrocele,  stricture,  fistula,  hemorrhoids,  or  vari- 
cose veins  of  lower  limbs. 

(n)  Phimosis  and  diseases  of  the  genito-urinary  organs. 

(o)  Ingrowing  nails,  bunions,  cross  or  hammer  toes,  flat  feet,  or  other  de- 
formity of  feet. 

(p)  Loss  of  many  teeth,  or  teeth  generally  unsound.  Marked  overbite,  or 
lack  of  occlusion  of  jaws.  There  should  be  at  least  eight  opposing  molars,  two 
ou  each  side  in  each  jaw.  All  defective  teeth  should  have  permanent  fillings. 
Much  time  can  be  saved  by  previous  attention  to  this  requirement. 

1982.  Attention  will  also  be  paid  to  the  stature  of  the  candidate,  and  no  one 
manifestly  under  size  for  his  age  will  be  received  at  the  academy.  The  height 
of  candidates  for  admission  shall  not  be  less  than  5  feet  2  inches  between  the 
ages  of  16  and  18  years,  and  not  less  than  5  feet  4  inches  between  the  ages  of 
18  and  20  years ;  and  the  minimum  weight  at  16  years  of  age  shall  be  111 
pounds,  with  an  increase  of  not  less  than  3  pounds  for  each  addit'onal  year, 
or  fraction  of  a  year  over  one-half.  Any  marked  deviation  in  the  height  and 
weight  relative  to  the  age  of  a  candidate  will  add  materially  to  the  considera- 
tion for  rejection. 

1983.  The  decision  of  the  medical  board,  especially  ordered  by  the  depart- 
ment for  the  examination  oi  candidates  for  entrance  to  the  Naval  Academy, 
upon  the  physical  qualifications  for  admission,  will  be  final.  (Department 
memo,  to  Bureau  of  Medicine  and  Surgery,  May  27,  1904.) 

1984.  Medical  officers  are  required  to  examine  physically  any  candidate  for 
the  Naval  Academy  who  may  appear  with  a  letter  from  a  Member  of  Congress 
so  requesting.  Special  attention  will  be  given  to  the  following  defects  or  dis- 
abilities: Flat  feet,  defective  vision  or  hearing,  heart  or  lung  trouble,  and 
disease  of  the  kidneys.  The  candidate  should  be  informed  of  the  result  of  the 
examination  and  a  copy  of  the  report  of  examination  shall  be  forwarded  to 
the  Member  of  Congress  concerned  and  a  duplicate  report  to  the  Bureau  of 
Navigation.  Each  examination  report  shall  show  the  name  of  the  Senator  or 
Representative  requesting  the  examination. 

1985.  Medical  examiners  should  bear  in  mind  that  the  primary  object  of 
this  examination  is  to  eliminate  those  who  are  obviously  disqualified,  rather 
than  to  give  assurance  to  any  candidates  that  they  will  subsequently  pass  the 
official  examination.  For  example,  candidates  who  appear  with  rapid  heart 
action,  without  organic  lesion,  should  be  informed  that  unless  such  condition  is 
temporary  they  will  probably  be  rejected.  Candidates  having  varicocele, 
hemorrhoids,  varicose  veins,  or  other  minor  surgical  defects  of  remediable  nature 
should  be  informed  that  they  will  probabily  be  rejected  unless  these  defects  are 
corrected  by  operation. 


122        MAKUAl.   FOK   TMK    MKDICAL  DEPARTMENT,  U.    S.    NAVY. 

1»86  lu  every  border-line  case  wherein  the  exauiiner  himself  is  uncertain 
as  trrthe  outcome  candidates  and  Members  of  Congress  should  be  clearly  la- 
formed  thai  the  case  is  a  doubtful  one.  (M.  &  S.  No.  124767.)  (^avy  Deyarf- 
ment  Circular  Letter  of  Oct.  17,  1913.) 

Section  6.— Instructions   Uklating  to  the  Physical  Examination   of 

Midshipmen. 

1091  In  the  examination  of  candidates  for  admission  as  midshipmen  into 
the  Naval  Academy,  medical  officers  shall  be  governed  substantially  by  the  in- 
structions contained  in  the  Navy  regulations  relating  to  the  physical  examma- 

°199"^  A'^hi-'h  standard  of  physical  excellence  is  essential  in  the  cases  of  all 
canrndates  presenting  themselves  for  admission  to  the  Naval  Academy,  and 
medical  officers  should  always  keep  in  view  the  fact  that  the  future  Physical 
efficiency  of  officers  of  the  Navy  will  depend  largely  upon  the  manner  in  which 
this  important  and  exacting  duty  is  performed  by  the  board. 

19J)3  A  careful  urinarv  analysis  shall  bo  made  in  the  case  of  every  candidate 
undergoing  examination.*  The  urine  shall  be  tested  qualitftiyely  and  (if 
deemed  necessary)  quantitatively  for  sugar  and  albumin.  \V here  albumin 
exists  in  appreciable  quantity  a  microscopic  examination  shall  be  made. 

'  1997.  Typhoid  prophylactic  shall  be  administered  to  all  persons  upon  entry 

into  the  service.     (I  3212.)  .     .        ,  «:        •„  „.,,.  ,...,.l- 

1998  No  per-son  shall  be  appointwl  or  commissioned  an  officer  in  an>  lank 
in  anv  class  of  the  Naval  Reserve  Force,  or  promoted  to  a  higher  rank  therein, 
unless  he  shall  have  been  examined  and  recommendetl  for  such  appointment, 
commission,  or  promotion  by  a  board  of  three  naval  officers  not  below  the  rank 
of  lieutenant  commander,  nor  until  he  shall  have  been  found  physically  qualified 
bv  a  board  of  medical  officers  to  perform  the  duties  required  in  time  of  war. 
ckcept  that  former  officers  and  midshipmen  of  the  Navy,  who  shall  have  en- 
rolled in  the  Naval  Reserve  Force,  may  be  appointed  in  the  grade  and  rank 
held  bv  them  without  cxanunation  other  than  the  physical  examination  herein 
prescribed.     (Geu.  Urd.  No.  237.    See  also  par.  2107.) 


:am 


CHAPTER  12. 


PHYSICAL  EXAMINATION  FOR  ENLISTMENT,  SPECIAL  DUTIES,  NAVY 
TARE*  SERVICE.  AND  UNDER  COMPENSATION  ACT. 

Section  1. — ENLisTjrENTS  in  the  Navt — Laws  Relating  to  Enlistment?."' 

2001.  Enlistment  ot  minors,  deserters,   insane,  intoxicated,  etc.,  prohibited. 
Sees.  1420,  1G24  (19)  R.  S. ;  acts  May  12,  1879,  Feb.  23,  1881. 

2002.  Term  of  enlistment.    Sec.  1573,  R.  S. ;  acts  Mar.  3,  1899,  Aug.  22,  1912. 

2003.  Term  of  enlistment,  minors.     Sec.  1418,  R.  S. ;  acts  May  12,  1879,  Feb. 
23    ISSl. 

2004.  Consent  of  parents  and  guardians  required  before  enlistment  of  minors. 
Sec.  1419,  R.  S.;  acts  May  12,  1879,  Feb.  23,  1881. 

2005.  Enlistments  in  the  Marine  Corps.    Act  Mar.  3,  1901. 

2000.   Physical  examination  oi  men  of  the  Naval  Militia  upon  muster  into 
service  of  the  United  States.     Act  of  Feb.  16,  1914. 

Section  2. — Navy  Regulations  and  Naval  Instructions  Relating  to  Physi- 
cal Examination  for  Enlistment. 

2011.  Ever\    oerson  enlisted  must  pass  physical  examination  prescribed  in 
medical  instructions  I  3201-3212;  R  3523  (1). 

2012.  Finger  prints  to  be  taken.    R  3523  (2). 

2013.  Records  to  be  made  of  persons  enlisted  with  physical  disability.     R 

8523   (3).  ,         ,.      ^ 

2014.  Minors  under  14  years  of  age,  insane,  and  intoxicated  not  to  be  enlisted. 

R  .3.524   (2). 

2015.  Reenlistments  authorized  if  physically  qualified.     R  3526. 

2016.  Continuous-service  men  disqualified.    R  3528. 

2017.  Entries  to  be  made  in  .service  record.    R  3541;  R  3542  (2). 

2018.  Marines  enlisted  must  pass  physical  examination.     R  41-51  (2). 

2019.  Reenlistment  of  marines  with  disability.    R  41.51  (3). 

2020.  Disabilities  to  be  entered  on  enlistment  papers.     R  41.51  (4). 

2021.  Persons  examined  physically  to  be  entered  on  card    (rough  Form). 
X).     I  3201. 

2022.  Examination  to  be  conducted  by  medical  ofTicer.    I  3202. 

2023.  Examination  to  be  completed  and  not  terminated  upon  discovery  of 
disqualification.     I  8203. 

2024.  Medical  oflieer  who  passes  recruit  subsequently  surveyed  to  be  held 
responsible.     I  3204. 

2025.  Inspection  and  inquiry  by  medical  officer.    I  3205. 

2026.  Intelligence  and  detection  of  mental  defects.     I  3206. 

2027.  Age  of  applicant  to  be  kept  in  mind.    I  3207. 

2028.  Entries  to  be  made  in  service  and  health  records.    I  3208. 

2029.  Defects  waived  by  department.    I  3209. 

2030.  Recruits  to  be  reexamined  on  receiving  ship.    R  3511 ;  I  3210. 

123 


124        MANUAL   FOR   THE   MEDICAL   DEPARTMENT^   U.    S.    NAVY. 

2031.  Recruits  to  be  immediately  vaccinated.    I  3211  (1). 

2032.  No  rocruit  to  be  transferred  until  vaccinated.     I  3211  (2). 

2033.  Typlioid  prophylaxis  to  be  administered.    I  3212. 

2034.  Examination  of  eyesight  of  gun  pointers.     I  2.501  (3). 

2035.  Naval  Reserve  Force.  R  4053  (b)  ;  I  5507  (b)  ;  I  5509;  Gen.  Ord.  Nos. 
231  and  237. 

Section  3. — Cikcular.s  Relating  to  Enlistment. 

2041.  Circular  relating  to  the  physical  examination  of  recruits  for  enlist- 
moiil-  in  the  Navy  and  Marine  Corps.     (N.  M.  S.  No.  112321-2.) 

2042.  Circular  relating  to  the  physical  examination  of  applicants  for  enroll- 
ment in  the  United  States  Naval  Reserve  Force.  (N.  Nav.  369;  N,  M.  S. 
127644.) 

2043.  Circular  relating  to  the  physical  examination  of  women  for  enroll- 
ment in  the  Naval  Coast  Defense  Reserve.     (N.  Nav.  380.    N.  M.  S.  127644.) 

Section  4. — Physical  Examination  of  Reckuits  fob  Enlistment  in  the  Navy 

AND  Marine  Corps. 

2051.  Whenever  any  person  is  examined  physically  for  the  Navy  or  Marine 
Corps,  whether  subsequently  enlisted  or  rejected,  his  name  and  the  particulars 
shall  at  once  be  entered  on  Form  X  (rough).  This  form  shall  be  prepared  for 
each  applicant  examined,  whether  accepted  or  rejected,  for  original  entry  or  re- 
enlistment,  and  will  be  kept  for  the  i)urpose  of  preparing  Form  X.  It  shall  be 
retained  for  ship  or  station  files  and  shall  be  filed  alphabetically,  by  calendar 
years  according  to  the  applicant's  surname,  in  order  that  information  may  be 
furnished  the  bureau  upon  request. 

Be  careful  to  strike  through  with  ink  the  term  not  applicable  to  the  case. 

Form  X  shall  be  prepared  from  the  Form  X  (rough)  kept  for  the  pury)ose, 
and  will  be  forwarded  from  receiving  .ships,  Navy  and  Marine  Corps  recruiting 
stations,  and  marine  recruit  depots  for  the  quartei*s  ending  March  31,  June  30, 
September  30,  and  December  31;  from  other  ships  and  naval  stations  or  yards 
for  the  year  ending  December  31.  or  when  a  ship  is  placed  out  of  commission 
or  a  recruiting  or  other  station  closed. 

A  copy  shall  be  retained  for  ship  or  station  files.  If  there  have  been  "No 
applicants"  the  report  shall  be  forwarded  and  this  fact  so  stated  in  the  blank 
spaces  opposite  "  Navy  "  and  "  Marine  Corps." 

Central  recruiting  stations  shall  include  in  their  report  the  substations  and 
traveling  parties  coming  under  their  jurisdiction. 

Medical  officers  of  ship.s,  naval  stations,  or  yards  making  examinations  for 
ships  or  stations  to  which  no  medical  oflicer  is  assigned  shall  include  these  items 
in  their  reports. 

Civilian  examiners  at  .substations  of  the  Marine  Corps  will  prepare  and  for- 
ward Form  X  (rough)  to  the  central  stations. 

2052.  In  case  a  waiver  Is  requested,  the  action  will  be  noted  after  the  cause 
of  n-ieition.  and  approval  of  waiver  shall  be  entered  in  the  service  and  health 
records.     (R  ;r.23   (.'});  I  3200.) 

2053.  Marine  lecruit  depots  shall  distinguish  between  "Accepted  applicants" 
transferred  from  recruiting  stations  to  the  depot  and  those  applying  originally 
at  tlK'  depot  by  making  the  proper  entry  in  the  space  provided  on  this  form. 

2054.  Previous  Army  service  shall  mil  be  <  oiisulered  a  reeulistniont.  Previous 
Navy  or  Marine  Corps  service  shall  be  considered  a  reenlistment  in  the  Navy, 
anil  previous  Marine  Corps  or  naval  service  shall  be  considered  a  reenlistment 
in  the  Marine  Corps,  so  far  as  it  ai»i>lies  for  use  in  the  preparation  of  this 
form. 

2055.  The  term  of  eniislnient  of  all  enlisted  men  of  the  Navy  shall  be  four 
years,  except  min«»rs  over  17  and  under  ]8  years  of  age,  who  sluill  be  enlisted 


MANUAL  FOR   THE   MEDICAL  DEPARTMENT,  "U".    S.    NAVY,        125 

for  the  period  of  minority.     Minors  under  17  can  not  enlist  in  the  Navy.    No 
enlistment  for  special  service  is  allowed. 

2056.  No  minor  under  the  age  of  18  years  will  be  enlisted  without  the  writ- 
ten consent  of  the  parent  who  Is  his  legal  guardian ;  or,  if  both  parents  are 
dead,  of  a  legally  appointed  guardian. 

Minors  under  but  claiming  to  be  over  18  years  of  age  are  liable,  if  enlisted,  to 
punishment  for  fraudulent  enlistment  iinder  the  act  of  Congress  approved 
Marches.  1S93. 

2057.  Only  such  persons  shall  be  enlisted  as  can  reasonably  be  expected  to 
remain  in  the  service,  and  when  enlisted  must  serve  out  the  term  of  their  en- 
listment, and  can  not  be  discharged  prior  to  that  time,  except  for  cause  or  as 
hereinafter  provided. 

2058.  Every  person  before  being  enlisted  must  pass  the  physical  examination 
prescribed  in  the  medical  instructions,  and  no  person  shall  be  enlisted  for  the 
naval  service  unless  pronounced  fit  by  the  commanding  and  medical  officers. 

2059.  No  person  other  than  a  medical  officer  shall  be  permitted  to  conduct 
any  part  of  a  physical  examination,  to  make  any  measurement,  or  to  make  any 
original  entry  on  any  medical  record  of  enlistment. 

2060.  Every  such  examination  must  be  completed  according  to  the  official 
forms  and  shall  in  no  case  be  suspended  on  the  recognition  of  a  disqualifying 
defect. 

2061.  Medical  officers  on  recruiting  duty  shall  exercise  great  care  and  thor- 
oughness in  conducting  the  physical  examination  of  persons  presenting  them- 
selves for  enlistme/it  While  these  instructions  are  applicable  in  general  to 
all  physical  examinations,  they  are  intended  to  cover  more  particularly  the 
examinations  of  applicants  presenting  themselves  for  original  enlistment.  While 
permitted  to  use  his  own  discretion  as  to  the  routine  of  procedure,  the  medical 
officer  shall  make  inquiry  on  all  points  indicated  below:  After  testing  the 
vision,  color  perception,  and  hearing,  and  estimating  the  general  fitness  of  the 
applicant,  his  height,  weight,  and  chest  measurements  may  be  taken  and 
recorded,  the  clothing  having  been  removed.  A  general  inspection  and  regional 
examination  is  then  made,  as  follows : 

(a)  The  applicant,  entirely  nude,  is  to  stand  before  the  examiner  in  a  bright 
light  and  present  successively  front,  rear,  and  sides.  (Retarded  development, 
deformity  or  asymmetry  of  body  or  limbs,  knock-knees,  bowlegs,  or  flat  feet, 
especially  in  minors :  spinal  curvatures ;  feebleness  of  constitution ;  strumous 
or  other  cachexia :  emaciation,  obesity ;  cutaneous  or  other  external  disease ; 
glandular  swellings  or  other  tumors ;  nodes ;  varicosities,  cicatrices ;  indica- 
tions of  medical  treatment,  leech  bites,  blister  stains,  seton  or  scarification 
scars ;  and  evidences  of  smallpox  or  successful  vaccination,  or  the  administra- 
tion of  salvarsan.) 

(b)  Applicant  to  present  dorsal  and  palmar  surfaces  of  both  hands;  to  flex 
and  extend  every  finger;  to  grasp  with  thumb  and  forefinger  and  with  whole 
hand;  to  flex  and  extend,  pronate  and  supinate  wrists  and  forearms;  to  per- 
form all  the  motions  of  shoulder  joints,  especially  circumduction ;  to  extend 
arms  at  right  angles  to  body,  and  then  bend  elbow  and  touch  the  shoulders  with 
the  fingers ;  to  elevate  extended  arms  above  the  head,  palm  to  palm,  then 
dorsum  to  dorsum ;  to  evert  and  invert  the  feet ;  to  stand  on  tiptoe,  coming 
down  upon  the  heels  quickly,  and  then  lifting  toes  from  floor ;  to  flex 
each  thigh  alternately  upon  the  abdomen,  and.  while  standing  on  one  leg,  to 
hop ;  to  perform  all  the  motions  of  the  hip  joint ;  and  to  walk  backward  and 
forward  slowly  and  at  double-quick.  ]■' 

(c)  Note  effect  of  these  violent  exercises  on  the  heart  and  lungs;  obsM^'^ 
movements  of  chest  during  prolonged  inspiration  and  expiration  ;  examine  by 
percussion  and  auscultation  front  and  rear.  (Incipient  tuberculosis,  valvular 
disease.)  Care  should  be  taken  to  differentiate  between  organic  murmurs  and 
the  functional  varieties. 

(d)  With  hands  on  the  head  and  chin  up,  applicant  to  cough  violently  (re- 
laxation of  umbilical  and  Inguinal  regions ;  hernia ;  concealed  venereal  disease, 


126        MANUAL    FOB   THE    MEDICAL   DEPARTMENT,   U.   S.    NAVY. 

especially  beii(*iitli  prepuce  and  within  un'tlira;  varicocele;  orchitis  and  otliei 
abnormal  conditions  of  testes).  ,    ^    ^      .  ,  4. 

(e)  Applicant  to  bend  body  forward,  with  knees  stiflened,  feet  wide  apart, 
hands  touching  the  fl(»or,  and  nates  exposed  to  strong  li«lit  (hemorrhoids;  pro- 
lapsus, fistula) .  While  the  ap)ilicant  is  sto(jpinf;  make  firm  pressure  on  the 
.spinous  process  of  each  vertebra  (noting  spinal  tenderness). 

(/)  Motions  of  head,  neck,  and  lower  jaw.  .         ^. 

(g)  Cranium  and  scalp  (malformations,  depressions,  cicatrices,  tmea,  ver- 
min, etc.).  „  .  ,    V 

(70   f:ars   (polypi;  otorrhea,  perforation,  dullness  of  neanng,  antl  degeneia 

tion  stigmata). 

(i)   Mastoid  region  for  scars  or  tenderness. 

(/)  Eyes  (absence  of  cilia?,  tarsal  redness,  obstructed  puntta,  corneal  opaci- 
ties, adhesions  of  iris,  defective  vision,  abnormal  conditions  of  conjunctivae, 
trachoma,  pterygium).  ,  ,  " 

.  ..(A-.)  Nose  (i>oly pi;  ozena;  chronic  na.sal  catarrh K 

.  (I)  Mouth,  teetii,  tongue,  fauces  (hyportn\.,liie.i  i..n.sUs;  syphilitic  attectioiis, 
impediments  of  speech,  lingual  scurs,  cleft  palate,  and  repulsive  stigmata  or 
scars  of  the  face,  grotesque  tattooing,  or  the  expression  characteristic  of  ade- 

""'>()02  No  educational  standard  has  been  officially  established  for  recruits 
nre'senting  themselves  for  enlistment  in  the  naval  service.  The  regulations 
reouiie  however,  that  a  candidate  shall  be  able  to  read  and  write  and  that  he 
should  posse.ss  a  reasonably  nuick  and  clear  understanding.  His  general  intelli- 
gence may  be  estimated  by  his  manner  of  answering  the  questions  addressed  to 
him  in  obtaining  tl\e  data  required  in  the  health  record,  and  any  impediments 

•^I)gS  Section  1420  of  the  Revised  Statutes  forbids  the  enlistment  in  the 
naval  service  of  any  intoxicated  person.  The  evident  intention  of  the  law  was 
not  only  to  prevent  the  admission  into  the  service  of  men  who  at  the  tune  of 
presenting  them-selves  for  enlistment  were  under  the  influence  of  alcoholic 
stimulants  or  drugs,  but  of  those  also  who  were  of  intemperate  habits.  A 
thorough  inquirv  should  he  made  into  the  history  of  any  applicant  in  which 
habits  of  intemperance  are  suspected.  Long  indulgence  in  hahils  of  uiteniner- 
ance  will  be  indicated  by  persistent  redness  of  the  eyes,  tremulousiu^ss  of  Uie 
hands  sluggishness  of  the  intellect,  satin-like  texture  of  the  skin  of  the  body, 
an  eruption  upon  the  face,  and  purple  blotches  upon  the  legs.  The  mori)hine 
habitue  is  often  emaciated,  prematurely  senile,  with  foul  breath,  contractetl 
pupils  peculiar  pallor,  dry  skin,  and  often  showing  multiple  punctures  ol  the 
skin  from  the  needle.  The  habitual  user  of  cocaine  niiiy  lie  suspecteil  when  the 
applicant  exhibits  unusual  buoyancy  and  mental  overactivity  accompanied  by 
li-relevant  volubility.  Cocaine  "  snufCers "  will  usually  show  a  characteristic 
hyperemia  of  the  nasal  mucous  membrane.  Medical  officers  should  endeavor 
to  eliminate  the  insane,  vagrant,  and  criminal  classes  by  a  careful  study  of  the 
per.sonal  characteristics  of  each  applicant.  .Uiy  doubt  as  to  the  mental  stability 
of  the  applicant  should  determine  a  careful ,  investigation  directed  toward  his 

previous  history.  .  .  .    ,      .^i    ,,        ,      . 

20G4.  Certain  defects  which  are  frequently  tound  associated  with  Uie  physi- 
cal condition  in  cases  of  reenlistmeut  or  continuous  service  are  not  mn-essarily 
caiLses  of  rejection.  If  deemed  of  sufficient  jmiiortaiice  to  cause  rejection,  a 
waiver  of  the  defects  may  be  reconunended,  provided  that  such  disabilities  will 
not  interfere  with  the  performance  of  duty.  Waiver  is  requested  on  "  Report 
of  rejection,"  procurable  from  Bureau  of  Navigation  (Form  No.  i>4).  Physual 
infirmities  incident  to  advanced  years  and  long  service  should  be  carefully  con- 
sidered in  the.se  examinations,  and  especially  in  the  case  of  reenlistmeut  under 
continuous  service.  Slight  pliysical  delects  in  tho.se  applicants  wiio  liave 
matured  are  of  less  importance  than  when  occurring  in  minors. 

Physical  disqualilications  of  a  minor  nature  of  i»robably  temporary  duration 
readily  amenable  to  m^Ulcal  or  surgical  treatment  should  not  ne«essnrily  fau<e 


MANUAL  FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.        127 

rejection  if  the  candidate  is  otherwise  qualified  and  desirable.  Application  will 
be  made  to  the  biu'eau  for  the  adniissiou  to  hospital  of  such  cases  as  super- 
numeraries for  treatment  of  such  duration  as  may  be  desirable,  having  in  view 
the  removal  of  disqualifying-  defects  and  the  ultimate  enlistment  of  a  candidate 
who  is  in  all  other  respects  qualified.  In  stating  the  cause  of  rejection  in  such 
cases  ambiguous  terms  should  be  avoided  and  the  degree  of  visual  and  auditory 
defects  should  be  given.     (M.  and  S.  No.  123734.) 

2065.  The  examining  surgeon  shall  cout^uler  carefully  the  physical  adapta- 
bility of  the  applicant  in  relation  to  the  character  of  the  duties  which  he  may 
be  called  upon  to  perform.  Moderate  height  and  compact  built  are  requisite 
in  the  ratings  of  fireman.  The  duties  pertaining  to  these  ratings  are  extremely 
ai'duous,  and  applicants  for  such  positions  and  candidates  for  transfer  to  these 
ratings  must  conform  in  every  particular  to  the  required  pliysical  standard.  As 
a  general  rule,  minors  should  not  be  recommended  for  the  ratings  of  fireman. 

2006.  Slight  physical  defects  in  applicants  who  belong  to  the  sealaring  class, 
or  in  those  who  have  had  experience  in  military  life,  have  less  significance  than 
they  might  otherwise  have  in  the  cases  of  recruits  whose  lives  have  been  passed 
in  occupations  of  a  more  confining  and  debilitating  character.  In  the  latter 
class  of  candidates  the  unusual  and  peculiar  services  that  would  necessarily  be 
exacted  of  them  might  develop  any  weakness  or  constitutional  physical  traits 
that  existed  prior  to  enlistment. 

20G7.  While  it  is  not  expected  that  candidates  for  special  ratings  should 
possess  the  physique  and  endurance  of  those  actively  engaged  in  strictly 
military  duties,  the  examining  surgeon  should  remember  that  all  candidates 
examined  for  the  several  special  ratings  are  enlisted  for  the  performance  of  all 
duties  pertaining  to  the  naval  service  ashoi'e  and  afloat. 

2068.  The  examining  surgeon  should  consider  carefully  the  physiognomy  of 
the  candidate.  Where  the  applicant's  face  is  marked  by  great  deformity,  warts, 
or  extensive  birthmarks,  he  shall  be  considered  undesirable  for  the  service  and 
shall  be  rejected.  ■ 

2069.  The  examining  surgeon  shall  exercise  the  greatest  care  in  the  examina- 
tion of  the  candidate's  feet.  Pronounced  flat  foot,  loss  or  deformity  <>f  the 
large  toe,  or  of  two  of  the  smaller  toes  on  one  or  both  feet,  partial  ankylosis 
of  the  ankles,  marked  callosities  or  ingrowing  toenails,  and  any  other  dc>fects 
which  in  the  opinion  of  the  examining  surgeon  may  interfere  with  marchmg  or 
prolonged  sentry  or  deck  duty,  shall  be  considered  causes  for  rejection  of  the 
applicant. 

2070.  The  absence  of  or  the  marked  deformity  of  the  right  index  finger  or 
thumb  shall  cause  the  rejection  of  the  applicant.  The  importance  attached  to 
the  absence  of  or  deformity  of  the  left  index  finger  or  thurub  will  depend  upon 
the  adaptability  of  the  applicant  for  his  special  rating,  provide<l  that  he  is 
otherwise  physically  sound. 

2071.  In  determining  the  weight  to  be  attached  to  slight  degrees  of  vari- 
cocele, varicose  veins,  and  hemorrhoids,  the  examining  surgeon  shall  carefully 
consider  the  age,  the  general  physique,  and  the  rating  of  the  applicant.  All 
candidates  with  hydrocele  shall  be  rejected,  also  all  candidates  with  varicocele 
when  accompanied  by  atrophy  of  the  testes,  pain,  or  an  evident  neurotic  state. 

2072.  Marked  enlargement  in  either  testicle  or  the  absence  of  both  testicles 
shall  cause  the  rejection  of  the  applicant.  Applicants  whose  clothing  exhales 
the  odor  of  urine,  or  who  present  any  evidences  of  incontinence  of  urine,  shall 
be  rejected.     Cases  of  epispadias  antl  hypospadias  shall  be  rejected. 

2073.  Every  recruit  must  have  at  least  20  sound  teeth,  and  of  these  not  less 
than  4  opposed  incisors  and  4  opposed  molars ;  but  if  otherwise  qualified  and 
desirable,  a  waiver  may  be  requested  in  the  case  of  a  candidate  not  having  4 
opposed  incisors  and  4  opposed  molars. 

2074.  The  examination  for  visual  acuteness  is  of  the  utmost  importance  and 
shall  be  conducted  by  the  medical  oflicer  with  the  gi-eatest  care  and  patience. 
An  appreciable  percentage  of  men  are  the  subjects  of  slight  visual  defects,  and 
in  the  cases  of  many  of  those  presenting  themselves  for  ree;ilistment  and  enlist- 


128        MANUAL  FOR   THE    MEDICAL  DEPARTMENT,   U.    S,    NAVY. 

meat  these  defects  may  not  be  sufTiciently  serious  to  disqualify  them  for  the 
naval  service.  The  Ignorance,  fear,  or  stupidity  on  the  part  of  an  applicant 
undergoing  examination  should  be  taken  into  consideration  by  the  examinins* 
surgeon,  and  unless  the  examination  is  conducted  with  care  and  deliberation 
an  applicant  may  be  rejected  whose  vision  is  really  good.  Slight  errors  on  the 
part  of  the  applicant,  such  as  misreading  a  P  or  T  for  an  F,  provided  the 
majority  of  the  letters  or  test  characters  are  read  with  facility,  need  not  be 
sufficient  cause  for  rejection.  The  examination  shall  be  conducted  In  a  large 
well-lighted  apartment,  and  the  test  cards  shall  be  placed  in  a  good  light  and  on 
a  level  with  the  candidate's  eyes.  The  applicant  stands  at  a  distance  of  20  feet 
so  that  line  of  vision  is  at  right  angles  to  the  test  card,  one  eye  being  tested  at  a 
time,  and  the  other  covered  by  a  card.  Vision  is  to  be  expressed  as  a  fraction,  of 
which  the  numerator  shall  be  the  distance  at  which  Snellen's  20-foot  test  can  be 
determined,  and  the  denominator  20.  Normal  vision  (20/20)  for  each  eye,  tested 
separately,  shall  be  required,  but  in  candidates  who  are  otherwise  physically 
sound  a  minimum  visual  acuteness  of  15/20  shall  sufTice.  The  existence  of 
several  minor  defects,  combined  with  a  visual  acuteness  of  15/20  in  each  eye, 
shall  cau.se  the  rejection  of  the  applicant. 

2076.  Color  perception  is  to  be  carefully  determined.  The  usual  examination 
is  by  Holmgren's  method,  which  may  be  brietly  described  as  follows  :  The  worsteds 
are  placed  in  a  pile  in  the  center  of  a  white  surface  in  good  daylight.  The  large, 
light  green  test  skein  is  placed  aside  upon  the  white  cloth,  and  the  person  to  l)e 
examined  is  directed  to  select  the  various  shades  of  the  same  color  from  the 
pile  and  place  them  by  the  sides  of  the  sample.  The  color-blind  will  make 
mistakes  in  the  selection  of  the  shades ;  or  a  hesitating  manner  with  a  disposi- 
tion to  take  the  wrong  shades  may  show  a  feeble  chromatic  sense.  The  purple 
test  skein  is  then  used.  If  the  test  with  the  green  skein  has  shown  the  person 
examined  to  be  color-blind,  and  on  the  second  or  purple  test  he  selects  only  the 
purple  skeins,  he  is  incompletely  color-blind ;  but  if  he  places  with  the  purple 
shades  of  green  or  gray,  he  is  completely  green-blind.  The  red  test  skein  need 
not  necessarily  be  used,  but  it  may  be  employed  to  confirm  the  diagnosis  already 
made;  for  the  red-blind  will  select,  to  match  the  red  skein,  shades  of  green  or 
brown  which  to  the  normal  sense  seem  darker  than  the  red,  while  the  green- 
blind  will  select  the  shades  of  green  or  brown  which  seem  lighter. 

2076.  The  organs  of  hearing,  both  the  conducting  apparatus  (outer  and 
middle  ear)  and  the  percipient  apparatus  (internal  ear)  must  be  free  from 
disease.  In  testing  the  hearing  of  the  applicant  advantage  should  be  taken  of 
the  absence  of  other  sounds  to  make  the  examination.  Medical  officers  should 
remember  that  the  applicant  may  be  totally  deaf  in  one  ear  and  yet  may  hear 
all  ordinary  conversation  perfectly  if  the  sound  ear  is  not  completely  closed. 
Deafness  may  be  caused  by  an  accumulation  of  hardened  wax,  therefore  an 
otherwise  desirable  recruit  should  have  his  ears  well  cleaned  before  final  action 
is  taken  in  his  case.  Hearing  shall  be  expressed  as  a  fraction,  of  which  the 
numerator  .shall  be  the  distance  in  inches  at  which  the  ticking  of  an  ordinary 
watch  can  be  heard,  and  the  denominator  40.  The  examiner  should  previ- 
ously standardize  his  watch  by  testing  hearing  of  Hospital  Corpsmcn  working 
with  him  whom  he  knows  to  have  normal  hearing.  If  the  voice  is  used,  hearing 
shall  be  expressed  as  a  fraction,  of  which  the  numerator  shall  be  the  distance 
in  feet  at  which  the  voice  of  the  examiner  can  be  beard  and  the  denominator  15. 
Re(|Uire<l  normal  hearing  is  therefore  15/1.").  The  voice  is  a  more  reliable 
method  of  determining  the  acuteness  of  hearing  than  the  watch  test,  as  it 
iiliows  for  variations  in  hearing  with  the  modifications  i)rodu('ed  by  changes  in 
I)itch  and  tone  and  the  voice  can  be  r.'used  if  there  are  noises  in  the  vicinity  of 
the  examining  room.  Complete  deafness  in  either  ear  shall  be  considered  n 
siiliicieiit  cause  for  rejection.  Before  completing  the  examination  the  medical 
officer  shall  satisfy  him.self  of  the  patency  of  the  eustachian  tubes  and  the 
integrity  of  the  tympanic  membranes. 

2077.  The  instructions  noted  under  "He.ilth  record,"  chapter  13,  sections 
3-5,  shall  be  strictly  followed  in  entering  data  required  on  the  health  record,  and 


MANUAL  FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.        129 

on  descriptive  list  in  service  record,  upon  enlistment.     (See  also  Form  X,  chap. 
25,  sec.  3.) 

2078.  In  every  case  of  rejection,  the  disability  unfitting  the  applicant  for 
service,  and  in  other  cases  any  abnormal  condition,  former  grave  illness,  or 
serious  injury  not  inconsistent  with  present  bodily  vigor  shall  be  entered  on 
Form  X   (rough). 

2079.  Recruits  presenting  themselves  for  enlistment  in  the  naval  service  shall 
be  rejected  by  the  examining  surgeon  for  any  one  of  the  following  conditions : 

General  disqualifications — 

(c)  Mental  infirmities:  Insanity,  idiocy,  imbecility,  dementia,  feeble  minded- 
ness. 

(ft)  Moral  infirmities:  Intemperance  in  the  use  of  stimulants  or  narcotics, 
evidence  of  felony,  masturbation,  sodomy. 

(c)  Diseases  of  the  cerebrospinal  system:  Epilepsy,  chorea,  all  forms  of 
paralysis,  tabes  dorsalis,  neuralgia,  stuttering  or  other  impediment  of  speech. 

(d)  Constitutional  diseases:  Feebleness  of  constitution,  poor  physique,  im- 
paired general  health  (tuberculosis?)  syphilis. 

Special  disqualifications — 

(e)  The  skin:  All  chronic,  contagious,  and  parasitic  diseases  of  the  skin, 
extensive  nevi,  deep  and  adherent  cicatrices,  chronic  ulcers,  vermin. 

(/)  The  head:  Abnormally  large  head;  considerable  deformities,  the  conse- 
quence of  fracture ;  serious  lesions  of  the  skull,  the  consequence  of  complicated 
wounds  or  the  operation  of  trephining;  caries  and  exfoliation  of  the  bone,  in- 
juries of  cranial  nerves,  tinea  capitis,  alopecia,  perforation  or  marked  deviation 
of  nasal  septum,  ozena,  nasal  polypi,  chronic  nasal  catarrh. 

(fir)  The  spine:  Caries,  spina  bifida,  lumbar  abscess,  rickets,  fracture  and 
dislocation  of  the  vertebrae,  angular  curvatures,  including  gibbosity  of  the 
anterior  and  posterior  parts  of  the  thorax. 

(h)  The  ears :  Deafness  of  one  or  both  ears,  all  catarrhal  and  purulent  forms 
of  acute  and  chronic  otitis  media,  polypi  and  other  growths  or  diseases  of  the 
tympanum,  labyrinth,  or  mastoid  cells;  perforation  of  the  tympanum;  closure 
of  the  auditory  canal,  partial  or  complete,  except  from  acute  abscess,  furuncle, 
or  impacted  cerumen ;  malformation  or  loss  of  the  external  ear  and  all  diseases 
thereof,  except  those  which  are  slight  and  nonprogressive. 

{i)  The  eye:  Loss  of  eye,  total  loss  of  sight  of  either  eye,  conjunctival  affec- 
tions, including  trachoma,  entropion ;  opacities  of  the  cornea,  if  covering  a  part 
of  a  moderately  dilated  pupil;  pterygium,  if  extensive;  strabismus,  hydroph- 
thalmia,  exophthalmia,  conical  cornea,  cataract,  loss  of  crystalline  lens,  dis- 
eases of  the  lachrymal  apparatus,  ectropion,  ptosis,  incessant  spasmodic  motion 
of  the  lids,  adhesion  of  the  lids,  large  encysted  tumors,  abscess  of  the  orbit, 
muscular  asthenopia,  nystagmus.  Any  affection  of  the  globe  of  the  eye  or  its 
contents;  defective  vision,  including  anomalies  of  accommodation  and  refrac- 
tion; myopia,  hypermetropia,  if  accompanied  by  asthenopia,  astigmatism,  am- 
blyopia, glaucoma,  diplopia,  color  blindness. 

(;■)  The  face:  Extensive  nevi,  unsightly  hairy  spots,  extensive  cicatrices  on 
the  face. 

(/o)  The  mouth  and  fauces:  Harelip,  simple,  double,  or  complicated;  loss  of 
the  whole  or  a  considerable  part  of  either  lip;  unsightly  mutilation  of  the  lips 
from  wounds,  burns,  or  disease;  loss  of  the  whole  or  part  of  either  maxilla, 
ununited  fractures,  ankylosis,  deformities  of  either  jaw  interfering  with  masti- 
cation or  speech,  loss  of  certain  teeth,  cancerous  or  erectile  tumors,  hypertrophy 
or  atrophy  of  the  tongue,  mutilation  of  the  tongue,  adhesion  of  the  tongue  to 
any  parts,  preventing  its  free  motion;  malignant  diseases  of  the  tongue;  chronic 
ulcerations,  fissures  or  perforations  of  the  hard  palate,  salivary  or  bucconasal 
and  thyroglossal  fistulse,  hypertrophy  of  the  tonsils  sufficient  to  interfere  with 
respiration  or  phonation.  Every  recruit  must  have  20  sound  teeth,  including  ,|t 
opposable  molars  and  incisors.  i„.^ 

98601°— 17 9  -  ' 


130        MANUAL   FOR   THE   MEDICAL   DEPAB^TMEKT,   U.    S.    NAVY. 

(0  The  neck:  Goiter,  scrofulous  adenitis  of  the  cervical  glands,  tracheal 
openings,  thyroglossal  or  cervical  tistulse,  wry  neck,  chronic  laryngitis,  or  any 
other  disease  of  the  larynx  which  would  produce  aphonia,  stricture  of  the 
esophagus. 

(m)  The  chest:  Malfoi-mation  of  the  chest,  or  badly  united  fractures  of  ribs 
or  sternum  sufficient  to  interfere  with  respiration ;  caries  or  necrosis  of  ribs, 
deficient  expansive  mobility,  evident  pretlisposition  to  tuberculosis,  chronic 
pneumonia,  emphysema,  chronic  pleuri.sy,  pleural  effusions,  chronic  bronchitis, 
asthma,  organic  disease  of  the  lieart  or  large  arteries,  serious  protracted  func- 
tional derangement  of  the  heart  or  distinct  predisposition  to  diseases  of  heart 
or  lungs. 

(«)  The  abdomen:  All  chronic  iuflannuations  of  the  gastrointestinal  tract, 
including  diarrliea  and  dysentery ;  diseases  of  the  liver  or  spleen,  including 
those  caused  by  malarial  iioisoning,  ascites,  obesity,  dyspepsia,  if  confirmed; 
hemorrhoids,  prolapsus  ani,  fistula  in  ano,  considerable  fissures  of  the  anus, 
hernia  in  all  situations,  tumors. 

(0)  Genitourinary  organs:  Any  acute  affection  of  the  genital  organs,  Includ- 
ing gonorrhea,  .syphilis,  and  venereal  sores ;  loss  of  the  penis,  phimosis,  If  com- 
plete, stricture  of  the  urethra,  loss  of  both  testicles,  undescended  testicle  or 
permanent  retraction  of  one  or  both  testicles,  chronic  disease  of  the  testicle  or 
epididymitis,  hydrocele  of  the  tunic  and  cord  unless  the  hydrocele  of  the  cord  is 
small  and  inconsequent,  atrophy  of  the  testicle,  marked  varicocele,  malforma- 
tions of  the  genitalia,  epispadias,  hypospadias,  but  a  slight  degree  of  hypo.spa- 
dias  not  preventing  the  normal  passage  of  urine  may  not  cause  rejection ;  incon- 
tinence or  retention  of  urine,  urinary  fistulis,  enlargement  of  the  prostate,  cal- 
culus, cystitis,  and  all  organic  diseases  of  the  kidney. 

(p)  Affections  common  to  both  the  upper  and  lower  extremities:  Chronic 
rheumatism,  chronic  diseases  of  joints  or  movable  cartilage,  acquired  or  con- 
genital deformities,  such  as  old  or  irreducible  dislocations  or  false  joints,  severe 
sprains,  relaxation  of  the  ligaments  or  capsules  of  joints,  dislocations,  fistulas 
connected  with  joints  or  any  part  of  bones,  effusions  into  joints,  badly  united 
or  nouunite<l  fractures,  defective  or  excessive  curvature  of  the  long  bones, 
rickets,  caries,  necrosis,  exostoses,  atrophy  or  paralysis  of  a  limb ;  extensive, 
deep,  or  adherent  cicatrices,  especially  of  burns,  contraction  or  permanent  re- 
traction of  a  limb  or  portion  thereof,  loss  of  a  limb  or  portion  thereof. 

(q)  The  upper  extremities:  Acquired  or  congenital  deformities,  such  as  frac- 
ture of  the  clavicle,  fracture  of  the  radius  and  ulna,  webbed  fingers,  permanent 
flexion  or  extension  of  one  or  more  fingers,  as  well  as  irremediable  loss  of  mo- 
tion of  these  parts;  mutilation  or  loss  of  right  thumb,  total  loss  of  the  index 
finger  of  the  right  hand,  loss  of  the  second  and  third  phalanges  of  all  fingers  of 
either  hand,  total  loss  of  any  two  fingers  of  the  .same  hand. 

(r)  The  lower  extremities:  Acquired  or  congenital  deformities,  such  as  vari- 
cose veins,  knock-knees,  clubfeet,  flat  feet,  webbed  toes,  the  bad  toes  double 
or  branching,  the  great  toe  crossing  the  other  toes,  hammer  toe,  bunions,  larger 
corns,  Overriding  or  superposition  of  any  of  the  toes  to  an  extreme  degree,  loss 
of  a  great  toe,  loss  of  any  two  toes  of  the  same  foot,  permanent  retraction  of  the 
last  phalanx  of  any  of  the  toes,  or  flexion  at  a  right  angle  of  the  first  phalanx, 
of  a  toe  upon  the  second,  with  ankylosis  of  the  articulation ;  Ingrowing  of  the 
nail  of  the  great  toe,  broniidrosis,  chronic  ulcers. 

2080.  Any  acute  disease  disqualifies. 

2081.  (a)  Kach  recruit  sliall  1h>  required  to  take  th6  oath  of  allegliance,  and 
further  state  that  the  stalfinent  he  makes  regarding  his  date  of  birth  and 
previous  naval  or  other  military  service  is  correct,  and  that  he  is  physically 
qualified  to  perform  the  duties  of  his  prospective  rating.  Tiio  examining  sur- 
geon certifies  on  the  shipping  articles  ns  follows:  "I  certify  tliat  I  have  care- 
fully examined,  agreeably  to  the  Reguhitions  of  the  Navy,  the  above  ii:inioil  re 
cruit,  and  find  that,  in  my  <)i)iiiion,  he  is  free  from  all  bodily  defects  and  men- 
tal Infirmity  which  would  in  any  way  disiiualify  Jiim  from  performing  the  duties 


MANUAL   FOR    THE   MEDICAL   DEPARTMENT,   U.    S,    NAVY.        131 

of  his  rating,  aud  that  he  has  stated  to  me  that  he  has  no  disease  concealed 
or  likely  to  be  inherited."  .       . 

(&)  (1)  On  account  of  insufficient  or  inaccurate  information  in  reports  of 
rejection  as  to  physical  defects  of  applicants  for  enlistment,  the  bureau  is  fre- 
quently unable  to  determine  whether  such  defects  should  be  waived,  and  such 
reports  are  often  returned  for  further  information  before  recommendation  can 
be  made.  ,  ,.     ,  .         ,      , , 

(2)  When  a  defect  is  curable  by  minor  operation  the  medical  examiner  should 
so  state  and  also  whether  the  applicant  agrees  to  operation  if  necessary. 

(3)  In  reporting  rejections  for  any  of  tlie  following  defects  the  bureau  de- 
sires that  the  information  as  noted  below  be  given : 

(4)  Flat  foot.—Give  degree  of  flatness,  stating  accurately  the  distance  be- 
tween the  tubercle  of  the  scaphoid  and  the  line  from  the  lower  border  of  the 
internal  malleolus  to  the  lower  tubercle  on  tlie  head  of  the  first  motatarsal. 
The  measurement  should  be  taken  standing  with  the  weight  of  the  body  on 
that  foot  and  when  the  foot  is  at  a  right  angle  to  the  leg  and  the  second  toe 
js  on  a  line  with  the  crest  of  the  tibia.  The  size  of  the  shoe  should  also  be 
given.  The  width  of  the  ball  of  the  foot  should  be  given  and  any  tendency  to 
talipes  valgus  noted.  ,^   ^    \ 

(5)  Bunions,  hammer  toes,  corns,  and  ingrowing  toe  nails  should  be  de- 
scribed accurately  as  to  location,  degree,  etc. 

(6)  Varicocele.— State  size  and  indicate  by  small,  medium,  or  large. 

(7)  Varicose  veins. — State  location,  extent,  and  size,  and  indicate  by  small, 
medium,  or  large. 

(8)  HemorrJioids.— State  character  and  size  and  indicate  by  small,  medium. 

or  large. 

(9)  Hydrocele. — State  size  and  indicate  by  small,  medium,  or  large. 

(10)  Hernia. — State  location,  size,  and  whether  incipient,  incomplete,  or  com- 
plete. Relaxed  rings  only  are  not  cause  for  rejection  unless  abdominal  walls 
are  weak  or  there  is  a  decided  impulse  on  coughing. 

(11)  Deformities. — State  location,  character,  degree,  and  amount  of  inter- 
ference with  motion. 

(12)  Contractures.— State  location,  degree,  and  amount  of  interference  with 
motion.  . 

(13)  Stiff  joint. — State  location,  degree  of  flexion  and  extension  obtainable 
and  the  strength  of  the  part. 

(14)  Defective  hearing.— State  degree,  giving  distance  by  watch,  by  the  whis- 
pered and  spoken  voice,  stating  whether  he  can  readily  hear  ordinary  conver- 
sation.   State  condition  of  the  external  canals  and  drums. 

(15)  Defective  vision.— State  defect  accurately,  whether  due  to  refractive 
error  or  other  disease ;  when  practicable,  giving  correction  by  lenses. 

(16)  Missing  or  defective  tceth.—State  in  detail  those  missing  or  unerupted 
and  those  defective,  using  diagram  for  that  purpose.  Also  state  whether  teeth, 
will  admit  of  proper  repair. 

(17)  Deficient  height  or  weight.— Always  state  age,  height,  and  weight. 

(18)  Tachyca7-dia.— State  cause,  character,  and  duration,  giving  time  dur- 
ing examination  for  applicant  to  recover  from  excitement  or  overexertion. 

(19)  Spinal  curvature. — State  location,  character,  and  degi'ee. 

(20)  Atrophy  or  hypertrophy  of  testicle.— State  degree  and  cause. 


132        MANUAL   FOR    THE   MEDICAL  DEPARTMENT,  U.    S.    NAVY. 

2082.    (a) — Table  of  physical  proportions  lor  height,  weight,  and  chest  meat- 

urement  of  adults, 

[Bureau  of  Navigation  Circular  relating  to  the  enlistment  of  men,  July  20,  1912.J 


Chest 

Height. 

Weight. 

(mean  cir- 
cumfer- 
ence). 

Inches. 

Pouiids. 

Inches. 

64 

12S 

33 

65 

130 

33 

66 

132 

33J 

67 

13» 

34 

68 

141 

34i 

69 

148 

34} 

70 

155 

35i 

71 

102 

36 

72 

169 

361 

73 

176 

30J 

(b)— Table  of  physical  proportions  for  enlistment  of  Filipinos. 


Age. 


IRtoM 

20  to  21 

22  and  over 


Height. 


61 

f.2 
62J 


Weight. 


Chest 
measure- 
ment 
(mean). 


105 
lOS 

110 


30t 
31' 
31J 


Expansion. 


2083.  The  minimum  height  for  acceptance  of  a  man  21  years  old  or  over  is 
64  inches  barefooted.  A  variation  not  exceeding  1  inch  is  permissible  if  the  ap- 
plicant is  in  good  health  and  desirable  as  a  recruit.  The  minimum  weight  for 
acceptance  of  a  man  21  years  old  is  128  poOnds.  A  variation  of  10  pounds,  not 
to  fall  below  128  pounds  in  weight  or  2  inches  in  clicst  measurement  below  the 
standard  given  in  the  table,  is  admissible  when  the  applicant  for  enlistment  is 
active,  has  firm  muscles,  and  is  evidently  vigorous  and  healthy,  except  for  en- 
listment In  the  rate  of  fireman  third  class,  for  whicli  rate  full  standard  meas- 
urements will  be  required.  A  chost  expansion  of  less  than  2  inches  in  a  minor, 
or  less  than  2^  inches  in  an  adult,  is  a  sufficient  cause  for  rejection  of  an  ap- 
plicant. The  table  is  given  to  show  what  is  regarded  as  a  fair  standard  of 
physical  proportions  and  not  as  an  absolute  guide  to  be  followed  in  deciding 
upon  the  acceptance  of  recruits. 

2084.  A  minor  enlisting  as  apprentice  seaman  must  conform  to  the  stand- 
ards noted  In  the  following  table,  which  Is  also  applicable  to  apprentice  musi- 
cians. United  States  Marine  Corps,  and  to  midshipmen,  (Circular  of  July  20. 
1912.) 


A I  17  years  of  age 
A I  1«  years  of  age 
At  19  ypiirs  of  ace 
At  20  years  ol  age 


Minimum 
height. 


Inches. 


Minimum 
weight. 


Pound'. 
110 
115 
120 
125 


Chest  ex- 
pansion. 


In-.hcs. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        133 

(If  the  age  is  6  months  in  excess  of  a  full  year  the  requirements  are  those  of 
the  age  at  the  next  birthday.) 

(No  underweight  or  underheight  is  allowed  in  minors. 

2085.  Marked  disproportion  of  weight  over  height  is  not  a  cause  for  rejection 
unless  the  applicant  is  positively  obese. 

2086.  (a)  Recruits  shall  be  vaccinated  within  24  hours  after  their  arrival 
on  a  receiving  ship  or  at  a  barraclis.  In  case  of  failure  the  operation  shall  be 
repeated  in  eight  days.  If  the  second  vaccination  is  not  successful  it  shall  be 
repeated  at  the  first  opportunity  with  a  vaccine  of  assured  potency.  The  only 
acceptable  evidence  of  successful  vaccination  is  a  pitted  scar  following  vaccina- 
tion. Results  of  vaccination  shall  be  recorded  on  the  health  record  and  reported 
on  the  quarterly  report  of  sick. 

(&)  No  recruit  in  the  Navy  or  Marine  Corps  shall  be  transferred  from  a  train- 
ing station,  receiving  ship,  barracks,  or  other  rendezvous  until  the  medical 
officer  is  satisfied  that  the  man  is  protected  against  smallpox. 

(c)  Every  enlisted  man  of  the  Navy  or  Marine  Corps  shall  be  vaccinated  upon 
reenlisting,  or  extending  enlistment,  unless  (a)  he  has  two  pitted  vaccination 
scars,  or  (b)  shows  evidence  of  a  previous  attack  of  smallpox. 

(d)  Every  officer  should  be  vaccinated  upon  appointment  immediately  upon 
reporting  at  his  first  station  for  duty,  and  the  fact  entered  on  his  health  record. 
Itevaccination  should  be  performed  at  least  once  in  every  seven  years  thereafter 
unless  he  has  two  pitted  vaccination  scars,  or  evidence  of  a  previous  attack  of 
smallpox.  The  responsibility  for  revaccination  shall  rest  upon  the  medical 
officer  making  the  annual  physical  examination  required  by  I  709  (5).  If  it  ia 
impracticable  for  this  medical  officer  to  perform  the  vaccination,  he  shall  notify 
the  proper  medical  officer,  through  official  channels,  so  that  it  may  be  carried 
out.  The  medical  officer  who  performs  the  vaccination  shall  note  the  result  of 
the  vaccination  on  the  officer's  health  record.     (I  3211.) 

(e)  If  possible,  all  members  of  the  Naval  Reserve  Force  should  be  vaccinated 
when  enrolled ;  if  this  is  not  practicable,  immediately  after  reporting  for  aetiv«^ 
duty. 

2087.  (a)  Typhoid  prophylactic  shall  be  administered  to  all  persons  upon 
their  first  entry  into  the  Navy  or  Marine  Corps. 

(b)  It  shall  be  administered  to  each  enlisted  man  upon  each  subsequent  en- 
listment, or  extension  of  enlistment,  who  is  under  4.5  years  of  age,  or  who  has 
not  had  a  well-defined  case  of  typhoid  fever.  The  medical  officer  making  the 
physical  examination  at  the  time  of  reenlistment  shall  start  the  administration, 
if  practicable;  if  not,  he  shall  notify  the  proper  medical  officer,  through  official 
channels,  so  that  the  administration  may  be  completed. 

(c)  The  administration  of  typhoid  prophylaxis  should  be  repeated  after  a 
period  of  four  years  for  all  persons  in  the  Navy  or  Marine  Corps  who  are  under 
45  years  of  age,  or  who  have  not  had  a  well-defined  case  of  typhoid  fever,  and 
the  medical  officer  making  the  annual  physical  examination  required  by  Article 
I  709  (5)  shall  be  responsible  for  its  administration.  If  it  is  impracticable  for 
him  to  give  the  prophylactic,  he  shall  notify  the  proper  medical  officer,  through 
official  channels,  so  that  it  may  be  given. 

{d)  The  only  acceptable  evidence  of  administration  of  the  prophylactic  shall 
be  the  entry  on  the  health  record,  signed  by  the  medical  officer.  (I  3212.)  The 
entry  should  be  In  red  ink. 

(e)  Typhoid  prophylactic  should  be  administered  when  a  newly  enrolled 
memlier  of  the  Naval  Reserve  Force  first  reports  for  active  duty. 

2088.  Medical  officers  are  required  by  act  of  February  16,  1914,  to  conduct  a 
physical  examination  of  men  of  the  Naval  Militia  when  mustered  into  service 
of  the  United  States.  The  physical  requirements  are  those  prescribed  for  the 
regular  service,  except  that  in  the  case  of  officers  the  minimum  height  is  5  feet 
4  inches.  Any  requirements  in  addition  to  these  may  be  made  by  the  States 
(Gen.  Ord.  No.  150.)      (See  par.  2297.) 

2089.  When  available,  medical  officers  will  make  such  examinations  of  mem- 
bers of  the  Naval  Auxiliary  Service  as  are  prescribed  in  the  regulations  for  that 
service. 


icW        MANUAL   i'OK   THE   MEDIOAL  DEPARTMENT,  U.   S.    NAVY. 

Section  5. — Navy  Rkgulations  ani>  Naval  Instbitotions  Relatino  to  Identi- 
fication Records  and  Finueu  PniNTS. 

2091.  Finger  prints  sent  to  Bareau  of  NavSfrtJtion.     R3523  (2). 

2092.  Reports.     I  5221  (18,  20)  ;  I  5249  (6)  ;  I  5261  (7). 

2093.  An  identification  record,  consisting  of  fiuser  prints  and  personal  de- 
scriptioii,  is  to  be  made  and  forwarded  to  tlie  Bureau  of  Navigation  in  the  casfe 
of  ever>'  man  enlisting  in  tlie  Navy,  and  to  tlie  Major  General  Commandant  In 
the  case  of  marines. 

2094.  Finger  prints  and  identiflcatif»n  records  are  not  required  upon  re- 
enlistment,  or  npon  discharge  for  undesirability. 

2095.  TIic  form  adopted  tor  recording  the  finger  prints  and  personal  descrip- 
tion (Form  No.  2.  Bureau-  of  Navigation);  (in  the  case  of  marines,  Form 
N.  M.  C.  330),  (I  5240  (6)  ;■  I  5261  (7)),  will  carry  the  finger-priut  record  on 
one  side  and  the  personal  desci'iption  on  tlie  other.  In  addition,  and  until 
furtlier  notice,  the  descriptive  list  called  for  on  the  service  record  (Form  No.  1, 
Bureau  of  Navigation)  will  be  filled  out  as  at  present. 

2096.  Instruriions  for  tlie  guidaiice  of  tiiose  concerned  in  making  and  for- 
warding "Identification  records": 

The  apparatus  for  taking  finger  prints  oonsists  of  a  form  holder,  an  ink 
plate,  and  a  roller  for  spreading  the  ink  on  the  plate. 

Keep  the  roller  and  ink  plate  clean  and  free  from  dust,  grit,  or  hairs,  and 
tlie  ink  tube  closed  when  not  In  use.  When  the  day's  work  is  finished  clean 
the  ink  from  the  plate  and  roller  by  means  of  a  clot",  and  benzine.  When  not 
using  the  roller,  rub  it  with  a  little  sweet  oil  or  lubricating  oil  before  laying  it 
away,  to  prevent  the  composition  from  becoming  too  hard. 

Preparatory  to  taking  finger  prints  squeeze  a  fimaU  quantity  of  ink  from  the 
tube  and  carefully  work  it.  by  use  of  the  roller,  into  a  thin  film  on  the  plate, 
the  spreading  of  wliich  may  be  facilitated  by  frequently  turning  over  the  roller. 
//  too  much  ink  is  used,  .'fte  impression  will  be  blurred  and  consequently  un- 
satisfactory. Th(;  thickness  of  the  ink  after  being  spread  on  the  plate  siiouid 
he  less  than  one-half  the  elevation  of  the  ridges,  and  this  can  be  tested  by  taking 
impressions. 

The  recruit  shoidd  wash  his  liands  thoroughly  with  soap  and  brush,  using, 
if  practicable,  running  water,  esi)ecial  care  then  being  taken  to  rinse  off  all  soap 
or  latlier  with  cold  water.  Failure  to  do  this  will  cause  white  hlotche.s  to 
appear  in  the  impression.s.  Immediately  before  placin'^  the  fingers  on  the  inked 
plate  the  fingers  .>hould  be  well  wiped  with  a  cloth  dampened  with  benzine  or 
ether,  which  should  remove  all  trace  of  grease,  water,  or  perspiration. 

Two  kinds  of  impressions  are  used,  "  plain "  and  "  rolled."  A  plain  Im- 
pression is  obtained  by  pressing  the  bulb  of  the  finger.  \\  ith  the  plane  of  the  nail 
parallel  to  *he  plane  of  the  plate,  on  the  inked  plate  and  then  on  the  paper  in 
the  same  manner.  A  rolled  impression  is  obtained  by  placing  the  side  of  ihe 
finger  on  the  inked  plate,  with  the  plane  of  the  nail  at  right  angles  to  the  plane 
of  the  plate,  and  rolling  the  finger  over  from  one  side  to  the  other  until  the 
plane  of  the  nail  is  again  at  right  angles  to  the  plane  of  the  plate,  but  with 
the  bulb  surface  of  the  finger  facing  in  the  opposite  direction,  thu.;  inking  the 
surface  of  the  finger,  and  then  rolling  the  finger  over  the  paper  in  the  same 
manner,  in  thi-<  way  obtaining  a  clear  impression  of  the  ridges  on  the  surface 
of  the  linger.  TMs  latter  injpression  should  include  both  the  palmar  surface 
and  the  sides  of  the  finger  between  the  ti[»  and  the  tlexure  of  the  last  .ioint. 
Always  roll  the  fingers  from  the  awkward  jiosition  tc  the  natural  position. 
(Pigs.  13.  14.  15.) 

It  is  absolutely  necessary  that  the  finger  prints  shall  be  clear,  that  the  ridges 
shall  be  distinctly  outlined,  and  that  the  "rolled"  Impres.slons  shall  be  sutli- 
clently  large  to  include  all  the  points  needed  for  accurate  classification,  and  free 
fiom  blur.  Black  impressions  are  better  tlian  light  onas  if  the  spaces  between 
the  ridges  are  fiee  from  blur. 

,    When  the  skin  of  the  iiin(iprs  is  in  poor  condiiion.  make  si>e«i(il  eflort  U*  get 
best  results,        ~ 


Fig.  hi.— Makiiif;  pluiii  iiuiirossiuii  of  lliij;ors. 


Fig.  17. — -Making  plain  iniprt'ssiun  ol  ihuinb. 


IVIAKTUAL  FOR    THE   MEDICAL   DEPAHTMENT,  U.    S.    NAVY.        135 

,,,  Entire  palmar  surface  of  nvsl  joint  should  be  joked  Sp.tUat  ^hoje  coutoy^'iOf 
pattern  will  be  shown  when  finger  is  rolled.  /    r  ;  ;   ■  r 

'  Recruit  should  first  be  required  to  sign  his  name,  and  then  to  roll  the  iiil- 
pression  of  the  right  index  finger  in  the  space  above  his  signature.  This  will 
eliminate  entirely  the  possibility  of  the  recruit  signing  other  thriu  his  own  Identi- 
fication record.  Have  only  one  recruit  at  a  time  present  in  the  room  where 
prints  are  being  made,  and  complete  and  file  each  record  before  the  nest  man 
enters  or  is  taken  up.  In  this  way  no  other  record  than  the  one  in  question  is 
available  or  within  reach  of  the  recruit  being  recorded,  therefore  he  can  sign 
no  record  but  his  own.  Do  not  allow  records  to  lie  around,  but  fi.le  or  ptherwisfe 
dispose  of  them  at  once  after  completing  examination.  ,  .    '        . 

.,  In  taking  impressions,  the  operator  himself  should  manipulate  the  hands  of 
lifie  recruit,  who  should  be  directed  to  relax  his  fingers  and  not  to  attempt  to 
assist  by  adding  to  the  pressure  on  the  inked  plate  or  on  the  paper.  In  order 
that  the  ink  may  be  taken  up  on  the  finger  evenly  and  in  sufl^cient  quantity,  an 
unused  part  of  the  plate  should  be  selected  each  time  for  inking  the  finger,  and 
when  no  unused  part  of  the  plate  remains  the  ink  should  be  redistributed  with 
tlie  roller  or  the  plate  reinked.  See  that  there  are  no  clots  of  ink  where  the 
fingers  are  to  be  rolled  on  the  plate. 

The  form  holder,  which  is  intended  to  prevent  the  form  from  moving  about 
and  blurring  the  print  while  impressions  are  being  taken,  will  be  used.  The 
best  results  will  be  obtained  with  a  table  that  places  the  form  holder  at  about 
the  height  of  the  elbow  of  the  recruit  when  he  is  standing  with  his  arms  hang- 
ing at  his  sides.  To  place  a  form  in  the  holder,  pi-ess  out  the  plate  by  means  of 
the  levers  at  the  ends,  place  the  form  in  position  under  the  plate,  and  push  back 
the  levers  to  their  original  position.  The  pressure  of  the  spring^  on  tJiie,  pliat^ 
will  hold  the  form  firmly  in  position.  '  J' .       '    ■  ' 

To  record  the  finger  prints  on  Bureau  of  Navigation  Form  No.  2  and  United 
States  Marine  Corps  Form  N.  j\I.  C.  330,  place  one  of  the  blank  forms  in  the 
holder  with  the  upper  heavy  black  line  appearing  just  above  the  upper  edge 
of  the  plate;  then  take  the  rolled  impressions,  in  the  order  named  and  in 
proper  spaces  on  the  form,  of  the  thumb,  index,  middle,  ring,  and  little  fingers 
of  the  i-ight  hand,  the  impressions  to  be  located  on  the  form  so  that  the  flexure 
of  the  last  joint  is  immediately  above  the  folding  line.  This  will  leave 'room 
for  a  second  print  to  be  taken  in  the  upper  part  of  the  space  in  case  the  first 
print  is  defective. 

After  the  impressions  of  the  fingers  of  the  right  hand  have  been  taken,  move 
the  form  in  the  holder  until  the  lower  heavy  black  line  .appears  just  above  the 
edge  of  the  plate;  then  take  the  rolled  impressions  of  the  fingers  of  the  left 
hand  in  the  proper  spaces  on  the  form. 

After  the  rolled  impression  of  each  finger  of  both  hands  has  been  obtained, 
again  move  up  the  form  in  the  holder  until  the  plate  covers  only  enough  of 
the  lower  edge  of  the  form  (not  exceeding  one-fourth  inch)  to  hold  it  in  place. 
Then  take  a  plain  impression  of  the  four  fingers  of  the  right  hand  at  one  time, 
the  fingers  being  held  together  so  as  to  bring  the  prints  within  the  allotted 
space,  and  a  similar  plain  impression  of  the  fingers  of  the  left  hand.  Below 
the  finger  impressions  take  a  plain  impression  of  each  thumb. 

The  method  of  obtaining  the  plain  impressions  is  to  take  each  of  the  fingei's 
in  turn  and  place  the  hulhs  only  on  the  inked  plate.  When  this  is  done,  press 
the  recruit's  fingers  together,  and  with  his  hand  limp  and  flat  (not  bowed  or 
arched)  place  it  in  the  space  shqAvn  on  the  form  and  press  each  finger  lightly 
at  the  base  of  the  nail.  No  attention  need  be  paid  to  the  deltas  in  the  plain 
simultaneous  impressions,  but  the  detail  nuist  be  clearly  defined.  These  im- 
pressions are  used  to  derermiue  if  the  rolled  impressions  are  in  their  proper 
sequence.     (Figs.  16  and  17.) 

A  finger  should  not  be  noted  missing  if  any  portion  of  it  beyohd  the  flexure 
of  the  terminal  joint  remains.  The  end  of  a  nnitilated  finger  should  in  all 
cases  be  inked  and  recorded  as  in  the  case  of  a  perfect  digit.  "^"'•"1"  hk  y'/^iil 

"iJiiii   i7iij    j»:>iJi*tL 


136        MANUAL  FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

Fi;?ure  1  shows  impressions  improperly  t.'iken.  This  record  is  so  blurred 
that  it  is  impossible  to  classify  the  impressions,  and  consequently  is  of  no 
value. 

No  amount  of  pressure  by  the  operator  should  be  used  in  making  or  inking 
rolled  Impressions.  It  is  the  pressure  that  causes  the  ink  to  more  readily 
run  in  between  the  ridges.  The  finger  tips  should  be  allowed  to  touch  the 
paper  only  with  sufficient  pressure  to  make  a  record. 

Figure  2  represents  the  only  standard  which  is  satisfactory^  and  it  is  desired 
that  no  record  be  forwarded  which  is  not  up  to  the  standard. 

The  utmost  care  should  be  taken  in  recording  the  impressions  of  the  little 
fingers.     From  these  fingers  a  subclassification  number  is  obtained. 

When  the  tinger-print  side  of  the  form  has  been  completed,  the  impressions 
Will  be  inspected  to  make  sure  that  they  are  clear  and  free  from  blur ;  that  all 
deltas  are  shown  in  the  rolled  impressions,  and  that  the  whole  contour  of  the 
pattern  is  shown.  The  rolled  impressions  will  also  be  compared  with  the  plain 
impressions  for  the  purpose  of  ascertaining  whether  they  are  recorded  in 
proper  sequence.  Any  defective  impressions  will  then  be  remedied  by  taking 
another  print  in  the  upper  part  of  the  proper  space  or  by  using  a  new  form,  if 
necessary.  If  the  impressions  are  not  recorded  in  proper  sequence,  a  new  form 
must  be  used,  the  oltl  one  being  destroyed. 

After  (he  finger  prints  have  been  taken  and  examined,  the  opposite  side  of  the 
form  will  be  filled  out  and  the  personal  description  completed  by  noting  on  the 
outline  figures  the  principle  identification  marks. 

Before  making  the  entries  on  the  personal  description  side  of  the  blank,  allow 
the  ink  on  the  finger-print  side  to  become  sufficiently  dry  to  prevent  blurring 
by  rubbing.  A  few  minutes  will  be  sufl!icient  if  the  form  is  handled  carefully 
and  not  rubbed  about  on  the  desk  while  the  personal  description  is  being  en- 
tered. A  sheet  of  blotting  paper  placed  under  the  form  will  protect  it  to  some 
extent.  If  an  impression  becomes  blurred  at  any  time,  a  new  impression  must 
be  taken  in  the  upper  part  of  the  proper  space,  or,  if  necessary,  the  imperfect 
form  should  be  destroyed  and  a  new  blank  used. 

A  delta  may  be  formed  by  the  bifurcation  of  a  single  ridge  or  by  the  abrupt 
divergence  of  two  ridges  that  hitherto  had  run  side  by  side,  thus : 


-\  -^ 


Fig. 


Th«'  core  of  a  loop  may  consist  of  an  even  or  uneven  numl)er  of  ridges, 
not  joined  together,  thus  : 


Fig.  -1. 


Arches. — In  arclies  the  ridges  run  from  mio  side  to  the  other,  making  no 
backward  turn.     An.-hes  have  no  deltas.      (Fig.  5.) 

T(.nted  anJicg.—ln  patterns  of  the  arch  type  the  ridges  near  the  middle  may 
have  an  upward  thrust,  arrunging  tlK-nisolves,  as  it  were,  on  both  .sides  of  a 
spine  or  axis,  toward  wliich  iKl.joiiiing  ridges  converge.  Tlie  ridges  (1ms  con- 
verging give  to  the  ]>att('rn  tli<'  appearance  of  a  tent  in  outline,  hence  the  name 
tented  arcli.     Tented  arches  have  no  deltas.     (Fig,  G.) 


Classification  Xo. 


;  rf  *^  ■ 


m 


<"5     W^ 


Fig.  1.— Imperfect  record.    Useless  for  classification. 


Fig.  2. — Trojiorly  muile  rcc-oni. 


*0>i 


Fig.  5.— Arch. 


Fig.  6.— Tented  arch. 


Point  of  core 


Fig.  7. 


-Radial  loop,  right  hand,  or  ulnar 
loop,  left  hand. 


Fig.  8.— Ulnar  loop,  right  hand,  or  radial 
loop,  left  hand. 


Fig.  9.— Whorl.    (2  deltas.) 


Fig.  10.— Composite.    (2  deltas.) 


Fig.  11.— L'luar  loop  (right  hand),  showing  05  points  of  ideniification. 


-jlO  this  form. 


Classification  A"(j. 

RIGHT     HANO. 


'3&  •'- 


LEFT     H  AISJ  D. 


,,   ■;i,„:.t.. 

7    1  i.;.-x. 

^     M.M!... 

..    I,   ■,.•. 

h-  •!  itil.-. 

•3. 

4. 

LEKT      HAMD. 

RIGHT      HANO. 

Fig  12.— 1   Whorl  improperly  rolled,  showing  only  one  delta:  2,  same  finger  properly  rolled;  3,  loop 
'  properly  rolled;  4,  same  finger  improperly  rolled. 


MANUAL   FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.         137 

111  loops  some  of  tlie  ridges  make  a  backward  turn  but  without  twist ;  there 
is  one  delta.  If  the  downward  slope  of  the  ridges  about  the  core  is  from  the 
direction  of  the  little  finger  toward  that  of  the  thumb  it  is  a  radial  loop.  Figure 
7  is  a  radial  loop  iu  the  right  hand.  Tlie  heavy  black  line  drawn  from  the 
delta  to  the  core  indicates  the  ridges  that  are  counted  in  classifying  loops.  In 
this  impression  the  line  cuts  or  crosses  16  ridges.  If  the  downward  slope  of 
the  ridges  about  the  core  is  from  the  thumb  side  toward  the  little  finger  the 
loop  is  ulnar.  Figure  8  is  an  ulnar  loop  in  the  right  hand  or  a  radial  loop  in 
the  left  hand.  In  this  impression  the  heavy  black  line  crosses  19  ridges.  Be 
sure  that  tlie  delta  is  shown  if  the  impression  is  a  loop. 

Whorls. — In  whorls  some  of  the  ridges  make  a  turn  through  at  least  one  com- 
plete circuit.  There  are  two  deltas.  Whorls  are  single  cored  or  double  cored. 
Fig.  9.)  The  right  and  left  deltas  in  this  impression  are  shown  by  the  arrow- 
heads. The  deltas  in  whorls  must  always  be  shown,  in  order  that  the  tracings 
may  be  properly  made.  In  whorls  the  ridge  traced  starts  from  the  left  delta 
and  is  traced  toward  the  right  delta.  When  the  ridge  whose  course  is  traced 
meets  the  cori-esponding  right  delta  ridge  the  whorl  is  specialized  as  M ;  when 
this  ridge  goes  inside  of  the  right  delta  with  three  or  more  ridges  intervening 
it  is  specialized  as  I ;  when  the  ridge  traced  goes  outside  of  the  right  delta 
with  three  or  more  ridges  intervening  it  is  specialized  as  O. 

Figure  10  is  a  composite.  This  pattern  is  classed  as  a  whorl  and  has  tvvo 
deltas.  The  right  and  left  deltas  in  this  impression  are  shown  by  the  arrow- 
heads. 

Figure  11  shows  ridge  characteristics  used  in  establishing  the  identity  of  a 
person.  Unless  an  impression  is  free  from  blur  great  difficulty  is  encountered 
in  picking  out  the  points  of  comparison  between  two  impressions.  Sixty-five 
points  of  comparison  are  shown  on  this  impression  which  are  free  from  blur 
and  could  all  be  used  for  purposes  of  comparison  and  identification  with  an- 
other print  of  the  same  individual. 

Figure  12  (1)  shows  a  whorl  improperly  rolled,  with  only  one  delta  showing. 
It  is  impossible  to  make  a  correct  tracing  of  a  pattern  rolled  in  this  manner. 
Figure  12  (2)  shows  the  same  impression  properly  rolled. 

Figure  12  (4)  shows  a  loop  improperly  rolled,  with  the  delta  missing.  The 
space  between  the  delta  and  point  of  core  in  loops  must  be  plainly  shown  and 
free  from  blur.  This  pattern  is  of  no  value  and  can  not  be  properly  classified. 
Figure  12  (3)  shows  the  same  pattern  properly  rolled. 

Each  operator  should  instruct  his  relief  in  the  taking  of  finger  prints,  so 
that  the  Bureau  of  Navigation  and  Marine  Headquarters  will  be  able  to  receive 
good  finger-print  impi-essions  at  all  times. 

The  skin  on  the  finger  tips  of  the  bodies  of  men  which  have  been  recovered 
from  the  water  will  be  greatly  wrinkled  or  shriveled,  so  that  without  some 
treatment  the  making  of  satisfactory  prints  may  be  difficult  and  even  impos- 
sible. The  way  to  overcome  this  is  to  inject  water  with  a  hypodermic  syringe 
beneath  the  skin  of  the  bulb  of  the  finger.  Tliis  will  smooth  out  the  skin 
for  the  impression. 

Figures,  5.  6,  7,  and  8  represent  the  standard  for  impressions  of  these  types. 
Only  impressions  of  these  types  which  are  up  to  the  standard  will  be  accepted. 

(r)  Name  of  recruit  will  be  entered  in  full. 

is)   Line  "Race"  will  be  filled  out  "White,"  "Negro,"  "Filipino,"  etc. 

(t)  The  complete  form  must  be  forwardetl  promptly,  with  the  first  sheet  of 
Enlistment  Record,  to  the  Bureau  of  Navigation,  and  must  not  be  folded. 
Duplicate  copy  for  retention  is  not  required. 

At  time  of  preparing  identification  tags  for  officers  make  also  finger  prints  for 
them  as  described  above. 

Note. — The  apparatus  for  making  finger  prints  is  supplied  by  the  Bureau  of 
Navigation,  and  not  by  the  Bureau  of  Medicine  and  Surgery. 

Platform  scales  and  other  paraphernalia  required  at  recruiting  offices  (except 
articles  on  the  Medical  Supply  Table)  will  not  be  furnished  by  the  Bureau  of 
Medicine  and  Surgery. 


138        MANUAL   FOR    THE   MEDICAL  DKPAJEITMENT,   U.    S.    XAVY. 
PifKi'AliATrON  OK  IDENTIFICATION  TAGS. 

(See  Qeneral  Order  294.)    ,  .r.;iii 

2097.  The  identliicatlon  tag  for  officers  and  enlisted  men  of  the  NaVy  fy>ur 
sists  of  an  oval  plate  of  monel  metal  1.25  by  1.50  inches,  perforated  at  one" 
eud  and  suspended  from  the  neck  by  a  monel  wire  incased  in  a  cotton  sleeve. 

The  tag  has  on  one  side  the  etched  finger  print  of  the  right  index  finger. 
On  the  other  side  are  to  be  etched  the  individual's  initials  and  surname,  the 
month,  day,  and  year  of  enlistment  (expressed  In  numerals,  e.  g.,  1-^1916), 
and  the  month,  day,  and  year  of  birth  (similarly  expressed).  This  side  \vll1 
"also  bear  the  letters  U.  S.  N. 

The  etching  of  the  tag  shall  be  done  by  such  member  or  members  of  the 
Hospital  Corps  as  the  medical  officer  may  designate. 

:The  following  articles  are  required: 
[■  1.  The  outfit  for  making  a  finger  print  on  paper. 

,2.  A  supply  of  printer's  ink  thinned  to  the  proper  consistency  for  ea.sy  use 
Svith  an  ordinary  steel  pen.     (Dilute  with  gasoline  or  turpentine.) 
'    3.  Gilsonite  or  powdered  asphaltum. 

4.  Nitric  acid,  1  part  by  volume ;  water,  2  parts  by  volume,  in  glass  dish. 

5.  Alcohol  lamp  \vith  good  flame  or  electric  stove. 

6.  A  device  for  holding  the  tag  without  touching  the  flat  surfaces  (not  sup- 
plied, but  device  can  be  improvised  by  any  carpenter's  mate). 

Tlie  steps  in  the  preparation  of  the  etchings  are  as  follows :  After  collecting 
the  various  articles  described  above,  take  an  ordinary  "  rolled  " '  finger  print 
on  paper  to  show  that  the  finger  is  clean,  not  too  heavily  inked,  etc..  and  will 
make  a  good  print,  and  write  down  on  paper  the  data  for  the  other  side — 
initiuLs,  surname,  and  dates  required.  Make  a  "rolled"  finger  print  (right 
index  finger)  on  the  metal  tag  in  the  usual  manner.  Holding  the  tag  by  the 
edge,  turn  It  over  and  write  on  the  other  side  with  a  clean  steel  pen  (in 
printer's  ink  that  has  been  thinned  out  with  turpentine  or  gasoline)  tlie 
initials  and  surname,  the  date  of  enlistment  and  of  birth  (using  figures), 
and  the  letters  U.  S.  N.  on  the  left  end  of  the  oval. 

While  ink  Is  still  frcsli  on  both  surfaces  sprinkle  them  with  finely  powdered 
asphaltum.  Some  of  this  will  mix  with  the  ink  and  stick  to  the  two  surfaces. 
The  rest  should  be  blown  off.  Now  heat  the  tag  slightly  above  the  boiling 
point  of  water.  Allows  the  tag  to  cool.  Put  It  in  the  nitric  acid  solution  for 
one  hour.     Remove,  wash  in  water,  and  dry. 

Great  care  is  to  be  exercised  in  the  preparation  of  the  tags  so  as  to  avoid 
useless  expense  for  tags  .spoiled  in  the  process.  The  following  cautions  are  to 
be  noted:  Remove  all  excess  of  ink  from  the  finger,  leaving  a  smooth,  uni- 
form coating.  Press  the  finger  lightly  against  the  metal  tag,  avol«ling  too 
great  pressure,  as  this  will  smear  the  Impression. 

If  the  first  impression  with  Ink  is  not  satisfactory,  make  it  again  on  a  fresh 
tag  Tags  that  have  been  soiled  with  printer's  ink  can  he  used  again  after 
thorough  cleansing  with  gasoline.  The  cleansing  must  be  thorouah,  as  the 
lea.st  trace  of  ink  left  on  the  tag  from  a  previous  attempt  will  spoil  (he  etciilng. 
(It  is  well  to  put  aside  the  tags  on  which  poor  printing  lias  l>een  done  and 
clean  them  up  all  at  one  time  for  use.)  .,.,... 

In  inscribing  the  name  use  a  blunt  pen  and  diluted  printers  Ink.  Tlte  Ink 
can  be  thinned  with  ga.sollne  or  turpentine.  Turpentine  1s  preferahle  as  it 
does  not  dry  so  quickly  and  the  next  step  must  be  carried  out  witli  both  sides  of 
the  tag  wet.  Have  the  initials,  siirname,  and  dates  writti'U  out  on  paper  in 
advance,  so  they  can  be  quickly  insf-rlbed  on  the  tag  without  having  to  delay 
bv  questioning  the  person  for  wlioin  tlie  tag  is  being  prepared. 

The  Ink  should  be  lust  thin  enough  to  write  wiUi.  If  it  spreads  on  the  iuet;il 
it  is  too  thin;  if  too  thick  it  will  not  flow  from  the  iwint  of  the  pen. 

*Fln)ser  prints  nrf  "  rojlod  "  and  plain:  see  sec.  2006. 


MA'NUAi;  FOK    THE   MEDIC  A  L   DEPARTMENT,   U.    S.    NAVY.        139 

Be  careful  not  to  smudge  the  finger  print  while  writing  name. 

The  next  step  is  the  apvilicntion  of  the  gilsonite  or  asphaltum.  This  should 
be  line  enough  to  pass  througli  a  sieve  having  100  meshes  to  the  square  inch. 
Sprinkle  thickly  on  llie  two  wet  surfaces.  Remove  what  does  not  mix  with 
and  stick  to  the  ink  by  tapping  and  blowing. 

The  tag  is  now  held  with  forceps  over  a  flame  or  stove  until  the  ink  and 
asphaltum  have  melted  toii:ether,  forming  sharp,  glossy  black  lines. 

If  not  enough  heat  is  applied  to  completely  melt  the  asphalt  the  action  of 
the  acid  will  be  too  powerful.  Complete  melting  of  the  asphalt  is  indicated 
by  the  lines  becoming  glossy.  If  too  much  heat  is  applied  the  lines  run  to- 
gether and  ai-e  obliterated.  The  etching  solution  consists  of  concentrated 
nitric  acid,  1  part  by  volume;  water,  2  parts  by  volume. 

The  solution  may  be  placed  in  glass,  china,  or  enameled  ironware  (if  there 
are  no  nicks  or  cracks).  A  number  of  tags  can  be  etched  at  once,  but  do  not 
pile  them  one  on  top  of  the  other.  The  name  side  should  be  up,  and  the 
linger-print  .side  down  while  in  the  acid  bath.  This  will  favor  deeper  etching 
on  the  name  side,  which  is  desirable,  as  it  will  then  not  wear  off  so  rapidly. 

The  etching  process  or  acid  bath  should  be  watched  and  a  tag  lifted  out  from 
time  to  time  to  see  how  lively  the  action  i-;.  It  can  be  moderated  by  adding 
water.  Usually  the  process  of  etching  requires  one  hour.  The  acid  solution 
naturally  weakens  'Ailh  use  and  should  be  renewed  from  time  to  time.  If  the 
corrosive  action  is  slow  in  beginning,  concentrated  muriatic  acid  (HCi)  may 
be  added — 1  part  to  every  30  of  the  nitric  solution. 

The  data  desired  are  put  on  thus : 


(First  enlistment.) 
(Date  of  birth  ) 

The  letters  "  U.  S.  N."  are  at  the  opjxxsite  eKd  of  the'roval  from  the  perforation 
for  the  wire.  ! 

In  the  case  of  officers  it  will  be  necessary,  wlien  making  the  tigs,  to.'make  also 
the  usual  finger  prints  on  jiaper  (as  required  for  enlisted  men)  and  to  send  them 
to  Bureau  of  Navigation,  Washington,  D.  C,  for  filing. 

Enter  on  the  blank  the  full  name  of  officer,  the  rante  held,  and  date  of  ap- 
pointment. f\'      !  '■ 

.  Section  6. — Outline  Figure  Cakd  and  DESc|feiPTrvE  List.  ^ 

2101.  The  outline  figure  on  the  reverse  side  of  the  finger-print  record  shall 
be  tilled  out  in  the  case  of  every  recruit  that  has  been  found  physically  qualified 
and  accepted  for  enlistment  and  for  every  sailor  or  marine  who  presents  him- 
self for  reenlistment  when  date  of  last  enlistment  was  prior  to  January  1,  1907. 

2102.  Medical  officei-s  on  recruiting  duty  shall  observe  the  greatest  care  in 
the  preparation  of  these  cards  and  shall  exercise  every  care  that  the  recoi'd  on 
each  card  may  be  complete. 

2103.  The  medical  officer  shall  make  a  careful  and  systematic  examination 
of  the  body  of  the  man,  front  and  rear,  on  each  side  of  the  median  line,  sepa- 
rately, commencing  at  the  scalp  and  ending  at  the  foot,  and  the  following  direc- 
tions shall  be  carefully  noted:  ;  -  •;  ■ 

{a)  Cards  showing  less  than  five  marks  in  addition  to  vaccination  scat's, 
tattooing,  loss  of  teeth,  and  deformities  (wliich  should  likewise  be  noted),  can 
not  be  relied  upon  in  the  effort  to  discover  identity  or  to  identify  a  per.son  in 
suspected  cases.  J]xperience  shows  that  as  many  as  10  or  1.5  marks  may 
usually  be  found. 


140        MANUAL  FOR   THE    MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

(b)  If  no  murks  l>e  foTind  upon  the  recruit  the  fact  should  be  stated  upon 
both  the  front  and  back  of  the  card.  If  marks  are  found  upon  the  front  and 
none  upon  the  rear  or  vice  versa,  the  entry  "  no  mark  "  should  be  made  ui)on  the 
appropriate  side  of  the  card.  , ,     ,    .  ,       ^, 

(t)  Outline  fiiiure  cards  are  to  be  made  out  in  permanent  black  ink.  Copy- 
ing ink  or  indelible  pencils  should  not  be  used. 


id)  Name— Christian  and  middle  name  in  full  and  suruame  iu  the  order 
to  be  used.  The  nanie  should  be  written  very  plainly,  or  prefei'ably  t^pewritt.-n 
or  printed  in  plain  Kotliic  letters. 

(c)   Rate —The  rate  in  wiiich  recruit  is  enlisted  shall  always  be  slated 
(/)  Age.— The  age  at  the  time  the  card  is  prepared  is  the  one  that  siuiU  be 
given. 


MANUAL    FOB    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.         141 

(g)  Height. — The  height  is  to  be  given  in  inches,  and  as  it  is  relied  upon  as  a 
base  in  comparing  the  cards  of  recruits  with  the  classified  descriptions  of  the 
former  sailors  or  marines,  and  as  the  measurement  may  to  a  considerable  degree 
be  affected  by  efforts  at  deception  on  the  part  of  the  recruit,  great  care  in 
ascertaining  it  is  enjoined. 

(h)  Hair. — The  scale  of  hair  colors  may  be  given  as  follovps:  Flax  color; 
light  brown:  of  red  hair,  as  follows:  brick  red,  sandy  red,  auburn  (reddish 
brown)  ;  dark  brown;  black ;  of  gray  hair,  as  follows:  dark  gray,  light  gray,  (ap-. 
preaching  white),  iron  gray  (mixed). 

(i)  Eyes. — The  eyes  should  be  compared  by  placing  the  subject  with  the  face 
in  good  light.  Slide  the  Standard  Eye  Chart  up  or  down  the  left  side  of  the 
face,  close  to  the  left  eye.  The  nearest  approach  in  similarity  of  color  is  the 
number  to  be  given.  If  the  right  eye  is  distinctly  different  in  color,  its  number 
also  should  be  given. 

(;■)  White  or  colored. — Write  the  word  "white"  or  "colored"  to  Indicate 
race  as  the  case  requires.     Do  not  indicate  by  crossing  out  one  of  the  words. 

(/c)  Date  of  last  prior  enlistment  in  the  Navy  or  Marine  Crops. — If  the  re- 
cruit has  had  no  prior  service  in  the  Navy  or  Marine  Corps,  write  the  word 
"  none." 

(I)  Missing  teeth. — To  indicate  the  missing  or  useless  teeth,  mark  with  an  X 
the  letters  corresponding  to  the  teeth  that  are  absent  or  useless.  Teeth  that 
are  partly  decayed  should  be  indicated  by  drawing  a  diagonal  line  through  the 
corresponding  letters.  If  none  are  missing,  write  the  word  "  no  "  in  front  or 
above  the  words  "  missing  teeth."  This  will  show  that  they  were  not  over- 
looked. 

(m)  Station  and  date.— Write  the  name  of  the  station  at  which  the  card  is 
made  out  and  the  date  of  its  preparation. 

2104.  Marks  on  the  outline-figure  card  should  be  made  at  points  corre- 
sponding to  those  occupied  by  the  marks  on  the  body  of  the  recruit.  This  may 
readily  be  accomplished  by  drawing  imaginary  lines  on  the  body  of  the  recruit 
like  the  dotted  lines  on  the  card  and  placing  the  mark  in  the  proper  position  on 
the  card.  As  the  dotted  lines  mark  the  boundaries  of  regions  which  are  used  in 
the  systematic  arrangement  of  the  cards  for  purposes  of  identification,  it  is 
important  that  each  mark  on  the  card  should  be  placed  in  its  proper  position. 

(a)  A  pen  picture  is  desired  of  all  marks,  showing  their  inclination  and 
general  shape.     In  the  case  of  tattoos  this  is  optional. 

( ft )  A  straight  line  should  be  drawn  from  each  mark  to  its  description  on  the 
right  or  left  of  the  figure.  When  avoidable  these  lines  should  not  cross  each 
other. 

(c)  When  a  description  is  common  to  a  number  of  marks,  it  need  not  be  re- 
peated for  each  one,  but  the  lines  may  converge  to  it,  if  they  can  do  so  without 
crossing  others. 

(d)  The  sizes  of  all  scars,  moles,  warts,  birthmarks,  etc.,  are  to  be  given  in 
inches  or  fractional  parts  thereof,  except  in  the  case  of  pin-head  moles  (abbrevi- 
ation p.  m.). 

(e)  Pin-head  moles  are  moles  less  than  one-eighth  of  an  inch  in  diameter. 
(/)  Tattoo  marks  should  invariably  be  noted  and  described  in  detail  as  tliey 

appear.  In  the  case  of  devices  composed  of  two  or  more  figures,  the  component 
parts  should  be  named,  e.  g.,  "  heart,  cross,  and  anchor,"  not  "  faith,  hope,  and 
charity  "  ;  "  clasped  hands,"  not  "  friendship  "  ;  "  eagle,  shield,  crossed  cannon, 
flags,  and  arrows,"  not  "American  coat  of  arms."  The  same  applies  to  all  em- 
blems, coats  of  arms,  lodge  pins,  badges,  etc. 

{g)  Letters,  initials,  and  words  should  be  printed,  by  ham  in  plain  romau 
capitals  or  gothic,  thus :  "J.  H.  M.,"  "  U.  S.  V.,"  "  I.  X.  L.,"  "  IN  GOD  WE 
TRUST,"  etc. 

(h)  Details  of  costume,  posture,  and  relationship  to  other  devices  should  be 
given  in  the  case  of  tattooed  representations  of  men  and  women,  e.  g.,  "  woman 
clinging  to  a  cross " ;  "man  and  woman  embracing,  houses,   lighthouse,  and 


142        MANIAI.    FOR   THE    MEDICAL   I>EP.\BTMENT,   U.    S.    NAVY. 

sliiij  ill   rlit  backi^iMUud  " ;   "  siiilor  standing  \>y   a  toiubstone,   weepiuf^  willow 
overliead,  cap  in  right  hand,  words  "  in  memory  of  my  mother'  on  stone." 

(0  The  size  of  tattoos  ueed  be  given  only  in  the  case  of  dots,  blotches,  cir- 
cles, lines,  etc. 

(;■)  It  is  not  necessary  to  state  the  color  or  kind  of  pigment  used  in  the 
tattooing. 

(k)  Do  not  crowd  the  description  of  tattoos  between  the  right  arm  of  the 
tigure  and  the  edge  of  the  card  in  front,  nor  the  left  arm  and  edge  of  the  canl 
on  the  back. 

(I)  Indecent  or  obscene  tattooing  Is  cause  for  rejection,  but  the  applicant 
•should  be  given  an  opportunity  to  alter  the  de.sigu,  in  whicli  event  he  uiaj ,  if 
■  otherwise  qualified,  be  accepted. 

(Hi)  Do  not  write  on  the  figure.  The  figure  is  to  be  used  for  the  pur- 
pose of  locating,  by  pen  pictures,  the  different  marks  found  on  the  body  of  the 
reciniit. 

(»)  Amputations  and  losses  of  parts  of  fingers  and  toes  should  be  noted, 
showing  the  particular  member  injui'ed  and  how  much  of  it  is  gone. 

2105.  The  following  abbreviations  are  authorized  and  will  he  undersrood  In 
the  sense  indicated,  viz:  Amp.,  amputation;  bl.,  blue;  bmk.,  birthmark;  bro., 
brown ;  d.,  depressed  (except  when  following  a  dimension ;  then  it  stands  for 
diameter)  ;  f.,  flat ;  fl.,  fleshy ;  h.,  hairy ;  m.,  mole ;  p.,  pitted ;  p.  m.,  pin-head 
mole;  r.,  raiseil ;  s.,  scar  or  smooth;  v.,  vaccination;  var.,  varicose  veins  or 
varicocele;  w.,  wart. 

(a)  All  combinations  of  the.se  abbreviations  are  admissible,  e.  g.,  p.  s.  i  d., 
pitted  scar  one-half  inch  in  diameter;  s.  1,  scar  1  inch  long;  f.  p.  s.  1  x  *.  an 
oval,  flat,  pitted  scar,  1  inch  long  and  i  inch  wide. 

(&)  Abbreviations  denoting  shape  are  unnecessary,  for  the  letter  "d"  fol- 
lowing a  dimension  shows  that  the  work  is  circular.  Two  dimensions  given 
indicate  that  the  mark  is  oval  or  oblong,  and  when  no  letter  follows  the  dimen- 
sion it  is  understood  that  the  mark  or  scar  is  linear. 

(c)   When  a  linear  mark  or  scar  is  otherwise  than  straight  the  length  to  be 
^giveu  is  the  shortest  distance  from  one  extreme  to  the  other. 
\     (d)  The  letters  "  T.  M."  should  not  be  used  as  abbreviations  for  "Tattoo 
marks,"  as  they  are  liable  to  be  taken  for  tattooed  letters  on  the  person. 

Section  6a. — Physical  Examination  fob  United  States  Naval  Resebve  Force. 

2107.  Candidates  for  enrollment  or  appointment  (or  transfer)  in  the  various 
ela.ssos  of  the  United  States  Naval  Reserve  Force  are  subject  to  the  physical 
requirements  prescribed  for  the  corresponding  ranks,  grades,  and  ratings  of  the 
Regular  Navy. 

Variations  from  standard:  Variations  from  the  standard  prescribe*!  are 
permissible  as  follows,  providetl  the  examining  medical  officers  are  satisfied 
that  the  delects  are  such  as  will  not  interfere  with  the  prospective  special 
duties  of  the  candidate  as  a  member  of  the  Naval  Reserve  Force.  Minimum 
height  for  officers,  04  inches.  Candidates  who  intend  applying  for  active  duty 
for  instruction  and  training  with  a  view  to  confirmation  in  grade,  and  the 
further  Intention,  when  authorized,  of  taking  the  examination  for  appointment 
in  the  Regular  Navy,  nuist  meet  the  Navy  standard. 

Fleet  Naval  Reserve,  class  1:  The  physiciii  standard  is  the  same  as  that 
for  the  Regular  Navy  as  applied  to  officers  appearing  for  promotion  and  men 
for  reonlistmcnt. 
,     Naval  Reserve,  class  2:  The  physical  standard  Is  the  same  as  for  class  1. 

Naval  Auxiliary  Reserve,  class  3:  Physical  exairiinations  in  this  class  will 
neces.sarlly  be  governed  by  the  ability  of  t\w  Individual  to  perform  the  duties 
of  his  po.sltion  as  a  member  of  the  crew  of  tlie  nierchant  ship  which  is  listed 
tc  be  taken  over  by  the  Navy  Departnient.  Conditions  which  do  not  prevent 
tJbe  individual  from  pursuing  his  occtipjitlon  on  the  ^lilp,  or  which  do  not 
menace  the  health  of  others,  nui.\    in  i.'cncnil  be  walvo.1  hy  tlio  oxaininiiiL;  )nodl- 


MANUAL   JFOB    THE   MEDICAL  DEPAETMENT,   U.    S.    NAVY,        143 

cal  officer.  All  defects  should  be  carefully  noted  in  the  health  record  and  ou 
the  shipping  articles,  and  a  waiver  form  noting  the  defects  should  be  made 
out  and  forwarded  to  the  Bureau  of  Medicine  and  Surgery,  marked  plainly 
"  For  file."  The  examining  medical  officer  should,  when  necessary,  insert  the 
words  "  except  as  noted  "  between  the  words  "  free  "  and  "  from  "  in  his  certifi- 
cate on  the  enrollment  articles. 

Naval  Coast  Defense  Reserve,  class  4 :  All  individuals  enrolling  In  this 
class  vdth  a  view  to  subsequently  taking  an  examination  for  appointment  in 
the  regular  Navy  are  required  to  meet  the  regular  Navy  standard.  All  individ- 
uals enrolling  in  this  class  who  are  capable  of  performing  special  useful  service 
in  the  Navy,  and  as  such  are  liable  for  general  service,  are  i*equired  to  meet 
the  standard  prescribed  for  class  1.  Individuals  who  are  enrolled  in  this  class 
for  special  or  fixed  duties  on  shore  will  be  only  required  to  meet  the  physical 
qualifications  prescribed  for  the  Naval  Auxiliary  Reserve,  class  3.  The  same 
procedure  with  regard  to  noting  and  reporting  defects  will  be  carried  out  as 
described  under  class  3. 

Naval  Reserve  Flying  Corps:  The  physical  standard  shall  be  that  prescribed 
for  the  Flying  Corps  of  the  regular  Navy,  except  that  when  individuals  present 
evidence  of  extensive  experience  in  actual  flying  a  waiver  may  be  forwarded. 
The  waiver  should  indicate  the  number  of  flights  and  the  total  time  recently 
spent  in  the  air  as  a  pilot. 

2108.  Female  candidates  for  enrollment  in  the  Naval  Coast  Defense  Reserve 
are  subject  to  the  following  physical  requirements: 

Table  of  physical  proportions  for  height  mid  iceiyht  meanaicment  of  loomen. 


Height. 

Weight. 

Height. 

Weight. 

Inches. 

Powndg. 

Inches. 

Pounds. 

60 

112 

66 

IS2 

61 

114 

67 

136 

62 

116 

68 

i-10 

63 

119 

09 

14.' 

M 

123 

70 

160 

65 

127 

The  weight  is  taken  with  clothing;  the  above  weights  are  those  after  the 
estimated  weight  of  clothing  has  been  deducted. 

The  minimum  height  for  acceptance  is  60  inches.  A  variation  not  exceeding 
1  inch  is  permissible  if  the  applicant  is  in  good  health  and  desirable.  The 
minimum  weight  for  acceptance  is  112  pounds.  A  variation  of  17  pounds,  not 
to  fall  below  95  pounds  in  weight,  below  the  standard  given  in  the  table  is 
admissible  when  the  applicant  for  enrollment  is  active.  A  chest  expansion  of 
less  than  2*  inches  is  a  sufficient  cause  for  rejection  of  an  applicant.  The  table 
is  given  to  show  what  is  regarded  as  a  fair  standard  of  physical  proportions 
and  not  as  an  absolute  guide  to  be  followed  in  deciding  upon  the  acceptance  of 
applicants. 

Marked  disproportion  of  weight  over  height  is  not  a  cause  for  rejection  unless 
the  applicant  is  positively  obese. 

Any  one  of  the  following  conditions  will  be  sufficient  to  cause  the  rejection 
of  an  applicant : 

(o)  Feeble  constitution,  general  poor  physique,  or  impaired  general  health. 

(b)  Any  disease  or  deformity,  cither  congenital  or  acquired,  that  would 
impair  efficiency,  such  as:  "Weak  or  deranged  intellect,  cutaneous  disease  not 
of  a  mild  type,  parasites  of  the  skin  or  its  appendages,  deformity  of  the  skull, 
abnormal  curvature  of  the  spine,  torticollis,  inequality  of  upper  or  lower  ex- 
tremities, inefficiency  of  joints  or  limbs,  deformity  of  joints  or  bones  (either 
congenital  or  the  result  of  disease  or  injury),  evidence  of  epilepsy  or  other 


144        MANUAL  FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

convulsions,  defective  vision  (miuiuium  15/20  in  either  eye),  disease  of  the 
eye,  color  blindness,  impaired  hearing  or  disease  of  the  ear,  chronic  nasal 
catarrh,  ozena,  polypi,  great  enlarsement  of  the  tonsils,  impediment  of  speech, 
disease  of  heart  or  lungs  or  predisposition  to  such  disease,  any  history  of 
abdominal  or  pelvic  disease  or  abnormality,  loss  of  many  teeth,  or  teeth  gen- 
erally unsound  (teeth  properly  filled  not  to  be  considered  unsound).  Every 
applicant  must  have  at  least  20  sound  teeth,  and  of  these  not  less  than  4 
opposed  incisors  and  4  opposed  molars. 

(c)  Any  acute  disease. 

Variations  from  the  standard  prescribed  are  permissible,  provided  the  exam- 
ining medical  officers  are  satisfied  that  the  defects  are  such  as  will  not  interfere 
with  the  prospective  special  duties  of  the  candidate  as  a  member  of  the  Naval 
Reserve  Force.  Conditions  which  do  not  prevent  the  individual  from  pursuing 
her  occupation,  or  which  do  not  menace  the  health  of  others,  may  in  general 
be  waived  by  the  examining  medical  officer.  All  defects  other  than  tho.se 
l>eculiar  to  the  female  sex  should  be  carefully  noted  in  the  health  record  and 
on  the  enrollment  articles,  a  waiver  form  noting  all  defects  shoud  be  made 
out  and  forwarded  direct  to  the  Bureau  of  Medicine  and  Surgery,  marked 
plainly  "For  file."  This  will  be  regarded  as  confidential.  The  examining 
medical  officer  should,  when  necessary,  insert  the  words  "  except  as  noted " 
between  the  words  "  free "  and  "  from "  in  his  certificate  on  the  enrollment 
articles. 

Whenever  a  naval  hospital  is  within  reach,  the  examination  shall  be  con- 
ducted at  said  hospital,  where  the  services  of  a  member  of  the  Nurse  Corps 
(female).  United  States  Navy,  w'ill  be  available.  If  this  is  not  practicable,  the 
examiner  shall  use  such  tact  and  courtesy  as  will  avoid  offending  in  any  way 
the  sensibilities  of  the  applicant.  He  shall  not,  however,  by  such  attitude, 
allow  himself  to  deviate  from  a  proper  fulfillment  of  all  the  requirements.  The 
applicant  should  be  previously  instructed  to  arrange  her  clothing  in  a  way 
that  will  insure  ease,  facility,  and  thoroughness  in  the  examination.  A  loose 
gown  of  light  material  will  not  interfere  with  the  examination  or  the  taking 
of  the  measurements.    Corsets  should  invariably  be  removed. 

Section  7. — Physical  Examinations  fob  Special  Duties. 

2111.  All  candidates  for  the  position  of  gun  pointer,  who  are  referred  by  the 
commanding  officer  to  the  medical  officer  for  examination  of  eyesight  prelimi- 
nary to  training,  shall  be  subject  to  the  following  requirements:  No  applicant 
shall  be  recommended  as  qualified  for  this  rating  who  can  not  read  with  the 
right  eye  (or  left  eye,  if  used  in  aiming)  at  20  feet  the  line  on  Snellen's  test 
card,  which  is  normally  .seen  at  15  feet  (i.  e.,  20/15  vision).  A  minimum  20/20 
vision  should  be  required  with  the  eye  not  used  in  aiming.  The  test  card  should 
be  well  illuminated,  on  a  level  with  the  candidate's  eyes  and  directly,  not 
obliquely,  in  front  of  him.  Before  each  record  target  practice  all  qualified  and 
acting  gun  pointers  shall  be  examined  for  acuity  of  vision  and  the  result  entered 
on  the  gunnery  record.  A  report  shall  also  be  submitted  to  the  departmept. 
(I    2r.01    (3)). 

2112.  In  all  cases  where  men  request  to  be  transferred  from  the  seaman 
branch  to  the  rating  of  fir?'man.  third  class,  they  shall  be  examined  physically 
by  a  medical  officer,  and  the  result  of  such  examination  reported  in  the  recom- 
mendation of  the  commanding  officer  wlioii  submitting  the  request  to  the  bureau. 
No  other  written  report  of  such  examination  need  be  made  other  than  an  entry 
i>n  the  man's  health  record  that  the  examination  has  been  made  and  (bo  man 
found  fit  or  unfit.     (Bureau  of  Navigation.    No.  2158-249.  Feb.  24,  1912.) 

2113.  Aviation  duty:  All  candidates  for  aviation  duty  shall  be  subjected  to 
a  rigorous  physical  examination  to  determine  their  fitness  for  such  duty. 
Physical  qualifications  shall  conform  to  the  standard  set  In  chapter  11,  with 
the  additional  requirements  as  follows: 


MANUAL   FOR  THE   MEDICAL  DEPARTMENT,  U.    S.    NAVY.        145 

(a)  Normal  vision  (at  least  20/20)  in  each  eye  will  be  required,  and  no 
variation  below  the  prescribed  minimum  standard  height  or  below  the  mean 
chest  circumference  and  the  prescribed  expansion  shall  be  allowed.  In  all  such 
candidates  a  normal  heart  and  normal  lungs  with  full  and  free  expansion  are  of 
prime  importance.  Blood  pressure  will  be  taken  before  and  after  exercise 
and  any  marked  departure  from  normal  will  be  cause  for  rejection.  A  urinary 
examination  will  also  be  made  and  disease  so  disclosed  will  invariably  lead  to 
rejection. 

(6)  In  requiring  normal  acuteness  of  vision  and  hearing,  medical  officers  are 
cautioned  to  recognize  that  such  acuteness  is  merely  one  factor  in  normal 
functions  of  eyes  and  ears,  separately  and  coordinately.  For  instance,  acci- 
dent in  landing  an  airplane  may  be  regarded  as  frequently  due  to  error  of  judg- 
ment In  regard  to  distance  from  earth  at  the  time  the  machine  should  be 
"  flattened  out."  Yet,  correct  judgment  depends  upon  many  factors  and  even 
simple  acuity  of  vision  can  be  considered  as  being  of  great  importance  at 
times  in  such  cases.  Furthermore,  while  judgment  may  depend  essentially 
upon  central  conditions,  it  also  has  important  relation  to  reflexes  from  eyes 
and  ears  which  may  dominate  those  conditions.  Therefore,  in  that  direction 
can  frequently  be  found  varying  ability  of  central  nervous  systems  to  main- 
tain coordination  and  a  normal  sense  of  equilibi'ium  with  reference  to  acts 
urgently  required.  Hence,  full  functions  of  eyes  and  ears  are  essential  for 
duty  in  the  Flying  Corps,  but  acuity  of  vision  and  hearing  is  only  a  part  of 
those  functions.  Nevertheless,  good  vision  is  very  helpful  in  selecting  a  suitable 
landing  field  in  forced  landings  and  in  allowing  efficiency  without  glasses  or 
goggles  that  can  be  pushed  out  of  the  way  when  obscured  at  any  time  by  oil 
(engine-in-front  type)  ;  while  normal  hearing  has  been  found  to  give  essential 
assistance  in  detecting  the  first  signs  of  engine  defect  while  in  the  air  or  in 
detecting  such  defect  pi'ior  to  flight. 

(c)  In  considering  eyes,  all  practicable  attempts  will  be  carefully  made  to 
seek  indications  of  abnormality  of  function  in  any  direction.  In  that  con- 
nection reference  is  made  to  requirement  of  even  pupils  and  equal  and  full  re- 
actions to  light  and  distance,  and  also  to  freedom  from  any  appearance  of  dis- 
ease in  eyes  and  adnexa.  Strabismus  or  squint  in  any  manifest  degree  is 
cause  for  rejection.  Ocular  movements,  observed  while  having  the  eyes  follow 
the  finger  of  the  examiner,  must  show  no  lack  of  coordination,  and  there  must 
be  no  nystagmus  on  turning  the  eyes  to  right  or  left  40  degrees  or  when  look- 
ing to  the  front. 

(rf)  In  relation  to  ears,  the  first  consideration  is  acuteness  of  hearing,  which 
will  be  determined  by  the  usual  methods ;  but  in  the  watch  test  the  examiner 
shall  use  a  watch  he  has  standai'dized.  For  that  purpose  he  shall  satisfy  him- 
self as  to  the  usual  average  maximum  distance  the  watch  is  heard  by  at  least 
five  men  found  to  have  normal  drums  and  considered  from  association  to  have 
normal  hearing.  The  determination  must  be  made  under  the  conditions  to 
which  candidates  would  be  subjected  in  carrying  out  the  test,  and  the  distance 
in  inches  so  determined  shall  be  used  as  the  denominator  in  computing  the 
usual  fraction  for  the  record ;  but  the  full  distance  will  be  required  for  accept- 
ance. The  drum  and  auditory  canal  of  each  ear  will  then  be  examined  with 
a  speculum.  Perforation,  pus,  odor,  or  any  evident  condition  of  disease  is 
cause  for  rejection.  Indication  of  middle-ear  trouble  shall  be  regarded  as  of 
special  importance,  and  it  should  be  recognized  that  such  indication  is  often 
found  in  the  very  diminution  of  the  sense  of  hearing  which  is  regarded  as  a 
cause  of  rejection.  A  contributory  cause  should  be  sought  in  examination  of 
nasal  septum  and  for  those  conditions  of  the  throat  and  nose  suggestive  of 
interference  with  patulousness  of  eustachian  tubes,  such  interference  not  only 
being  in  association  with  middle-ear  disturbances,  but  also  preventing  the 
aviator  from  securing  the  required  balance  of  air  pressure  on  the  ear  drums 
when  ascending,  or,  of  special  importance,  in  more  or  less  rapid  descents. 

98601°— 17 10 


146        MANUAL   FOE   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

(c)  The  practicability,  or  even  advisability,  at  this  time  of  seeking  to  make 
«lefinite  inquiry  into  functions  of  equilibrium  through  nystagmus  induced  by 
cxcitMtion  of  vestibular  mechanism  may  be  regarded  as  more  or  less  in  question 
in  view  of  normal  differences  and  also  of  variations  in  the  personal  equations 
of  examiners.  Such  nystagmus  may  be  produced  by  rotary,  caloric,  compres- 
sion, or  galvanic  methods. 

(/)  However,  in  seeking  abnormality  in  function  of  equilibrium  there  are 
certain  valuable  static  and  dynamic  tests  that  must  be  made  at  each  examina- 
tion. In  these  tests  (he  candidate  is  required,  without  shoes,  and  first  with  eyes 
open  and  then  closed,  to — 

(1)  Stand  with  knees  well  back  and  inner  margin  of  feet  touching. 

(2)  Stand  on  toes  from  position  (1). 

(3)  Stand  flat  on  right  foot  and  rest  left  foot  on  right  knee  or  instep. 

(4)  Stand  Hat  on  left  foot  and  rest  right  foot  on  left  knee  or  instep. 

(5)  Walk  forward  with  feet  flat. 

(6)  Walk  to  the  right  in  a  circle  with  feet  flat. 

(7)  Walk  to  the  left  in  a  circle  with  feet  flat. 

(8)  Walk  backward  with  feet  flat. 

(9)  Hop  backward  on  both  feet  flat. 

(10)  Hop  backward  on  right  foot  flat. 

(11)  Hop  backward  on  left  foot  flat. 

Position  (1)  should  be  held  for  two  minutes  without  abnormal  swaying,  and 
position  (2)  for  a  minute.  Normal  attempts  at  balancing  have  no  significance. 
Positions  (3)  and  (4)  should  be  held  for  at  least  a  quarter  of  a  minute.  In 
tests  (6)  and  (7)  there  should  not  be  expectation  of  candidate  making  mathe- 
matical circle,  especially  with  eyes  closed,  but  only  that  he  will  normally  tend 
to  follow  the  general  direction  of  a  circle.  In  making  these  tests  and  watching 
for  abnormal  deviations,  the  examiner  must  recognize  that  they  liave  relation 
not  only  to  peripheral  nerve  disturbances  but  also  to  central  conditions,  esi)e- 
(.ially  those  of  luetic  origin,  and  that  tlie  patella,  tendo  Achillis,  and  pupillary 
reflexes  must  be  considered  with  them.  In  the  case  of  the  candidate  examined 
for  transfer  or  detail  the  blood-serum  test  for  specific  disease  will  also  be 
secured,  and  such  test  will  be  secured  in  other  cases  when  practicable. 

(g)  The  static  and  dynamic  tests  must  also  be  considered  in  connection  with 
the  prescribed  routine  examination  to  determine  the  free  and  full  movements 
of  joints.  In  relation  to  the  knee  and  ankle  joints  it  is  evident  that  their  finer 
movements  play  a  very  important  part  in  rudder  control,  especially  in  a  fast 
machine  requiring  qui'clc-acting  controls.  Difficulty  in  those  joints  may  also 
lead  to  the  abnormal  position  in  an  airplane  that  tends  to  cramping  of  muscles, 
(/t)  In  the  consideration  of  a  suitable  type  of  individual  the  anemic  should 
be  discarded,  and  also  the  asthmatic,  emphysematous,  or  obese.  The  desire  is 
for  the  active  with  freedom  from  disease  and  objectionable  tendencies.  In  that 
relation  the  history  of  the  individual  may  be  of  great  importance  and  con- 
sequently must  be  sought.  Is  there  story  of  eye  trouble,  such,  for  instance,  as 
double  vision?  Is  there  history  of  ear  trouble,  such  as  earache,  discharge, 
nolse.s,  or  mastoiditis?  What  is  the  history  as  to  enuresis,  asthma,  rheinnntism. 
.seasickness,  swing  sickness,  vertigo,  headache,  and  head  injury?  Those  ques- 
tions relate  to  both  disease  and  type  and  can  readily  furnish  information  upon 
which  rejection  should  be  based.  A  candidate  whose  history  or  condition  shows 
lues,  or  any  of  the  chronic  intestinal  di.sordcrs  tending  to  dizziness,  should  be 
rejected  as  well  as  he  who  is  found  to  have  inclination  towanl  a  habit  that 
disturbs  mental  balance,  such  as  toward  alcohol  or  other  drug. 

(i)  In  either  adult  or  minor  a  chest  expansion  of  less  than  2A  Inches  is  a 
sulficient  cause  for  the  rejection  of  the  applicant,  and  there  shall  be  no  varia- 
tion below  the  pre.sci-ibod  chest  measurements.  In  the  case  of  minors  no  under- 
weight or  undcrheight  is  allowed,  and  in  regard  to  adults  the  weights  given 
for  04  G5,  and  GG  inches  will  be  regarded  in  each  case  as  a  minimum.  X«» 
adult  above  CG  inches  will  be  accepttxl  with  less  weight  than  132  pounds,  an(' 


MANUAL   FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.        147 

iu  such  a  case  no  variation  greater  than  7  pounds  below  the  prescribed  weight 
for  height  will  be  allowed.  But  in  all  cases  the  applicant  must  be  active,  with 
firm  muscles,  and  evidently  vigorous  and  healthy.  Consequently,  marked  dis- 
proportion of  weight  over  height  will  also  be  a  cause  for  r.ejection  when  it  is 
an  indication  of  obesity.  Special  attention  will  be  given  to  obesity  and  to  any 
tendency  in  that  direction  disclosed  by  family  history  or  suggested  by  dispro- 
portion of  weight  over  height.  Examiners  will  regard  obesity  or  tendency  to 
obesitv  as  cause  for  rejection  in  all  cases. 

2114.  Physical  examination  of  men  recommended  for  trial:  Commanding 
officers  recommending  a  man  for  trial  by  general  court-martial  will  direct  the 
senior  medical  officer  on  board  to  make  a  thorough  physical  examination  of  the 
man  so  recommended  for  trial  to  determine  his  physical  fitness  for  the  service. 
In  case  the  man  so  examined  shall  be  found  physically  unfit  for  the  service, 
the  report  shall  fully  contain  the  reasons,  etc.  The  report  shall  be  made  in 
deplicate,  and  will  be  forwarded  to  the  commander  in  chief  with  the  other 
papers  in  the  case.     (Atlantic  Fleet  Regulations,  1913,  par.  260  (h).) 

2115.  Phvsical  examination  of  prisoners  prior  to  transfer  to  disciplmary 
ship-  In  every  case  before  a  general  court-martial  prisoner  is  trausferretl 
to  a  disciplinary  ship  an  examination  will  be  held  by  a  medical  officer  of  the 
ship  to  which  the  prisoner  is  attached  to  determine  the  prisoner's  physical 
fitness  for  the  service,  and  no  prisoner  found  to  be  physically  unfit  will  be 
transferred  to  a  disciplinary  ship.  A  report  in  duplicate  should  be  submitted. 
(Department  letter  No.  26267-81:1,  of  Jan.  9,  1913.)      (Procedure  on  shore, 

eee  par.  2947.)  ,      .  .    ,     ^         -        -,  ^ 

2116  Examination  before  transfer:  Every  man  about  to  be  transferred  from 
one  ship  or  station  to  another  shall  be  subjected  to  a  careful  phtjsical  exami- 
nation conducted  by  the  medical  officer,  who  shall  make  the  requisite  entries 
on  the  man's  health  record.  Except  in  an  emergency,  no  man  who  is  known 
to  have  been  exposed  to  any  infectious  or  contagious  disease,  or  who  is  found 
to  be  suffering  from  such  disease  or  from  active  venereal  infection,  which 
mav  be  a  menace  to  others,  shall  be  recommended  for  transfer  except  for  treat- 
ment in  hospital  or  for  passage  thereto.  When  an  emergency  requires  the 
transfer  of  men  with  these  diseases,  a  full  report  shall  be  forwarded  through 
official  channels  to  the  medical  officer  of  the  ship  or  station  to  which  transfer 
is  made  with  such  recommendation  as  the  medical  officer  may  deem  advis- 
able If  any  cases  of  these  diseases  are  found  and  retained,  they  shall  be 
promptly  admitted  for  treatment  and  a  report  of  the  fact  made  to  the  com- 
manding officer.  (R  3581  (5).)  ,  .^  ^  *  x-  „ 
2117.  When  practicable,  applicants  for  the  rating  of  mess  attendant,  natives 
of  Insular  or  tropiral  possessions  of  the  United  States,  will  be  examined  for  the 
presence  of  intestinal  parasites,  and  such,  if  found,  will  constitute  cause  for 
rejection.  • 

Section  S.— Naval  Instructions  Relating  to  the  Navy  Yard  Service,  Physi- 
cal Examination  undee  Compensation  Act,  Etc. 

2121.  Physical   examination   of  applicants  for  employment  at  navy   yardS; 

(civil  employees).     I  231   (9).  ,       t  o--.  /oi^  » 

2122.  Qualifications  (physical)  of  applicants.     I2ol(21)(Z. 

2123.  Causes  of  rejection.     1251  (23). 

2124.  Authorization  of  compensation  for  injury.     1391. 

2125.  Medical  examination  every  six  months.    1391  (1)  e. 
212(>.   Prevention  of  injury  to  eyes.     1392  (1). 

2127.  Letter  of  Seci'etary  of  (Jominerce  and  Labor  relative  to  importance  of 
physical  examination  by  the  medical  officer  of  a  navy  yard.     I  393. 

2128.  Civil  employees  at  naval  hospitals.     1401  (1). 

2129.  Extension  of  leave  when  ill.    1402  (2)  (5). 

2130.  Leave  when  contagious  disease  exists  in  family.    1403  (2)  a,  b. 

2131.  Leave  on   account  of   sickness  and    medical   certificates.     I   404  (2). 
(Navy  Department,  circular  letter.  May  2G.  1917.) 


148        MANUAL  FOR  THE   MEDICAL   DEPARTMENT,  U.    S.    NAVY. 

2132.  Tlio.se  honorably  discharged  from  Army  or  Navy  for  disability  in  line 
of  duty  to  be  liven  preference  for  appointments.     (R.  S.,  sec.  1754.) 

Section  9.— Detailed  Dibections  Regarding  Navy  Yard  Service  and  Duties 

ON  THE  Labor  Board. 

2141.  The  physical  examination  of  applicants  for  all  positions  will  be  con- 
ducted wholly  with  a  view  to  determinins;  an  applicant's  ability  to  perform  the 
work  of  the  position  to  which  he  seeks  appointment,  and  his  free(l<im  from  dis- 
ease or  defect  which  would,  as  a  contributory  cause,  tend  to  apirravate  or  pro- 
long a  disabilitv  resulting  from  accident  or  injury  received  in  the  performance 
of  his  work,  or'which  would  render  him  more  liable  to  such  accident  or  injury. 
(I  231(9).) 

2142.  An  applicant  is  required  to  show  to  the  satisfaction  of  the  labor 
board  that  he  is  phvsicallv  able  to  perform  the  work  of  his  occupation  or  trade, 
and  that  he  has  no  physical  defect  which  will  tend  to  prolong  any  disability 
present  or  render  him  more  liable  to  accident  or  injury.  (I  251  (22)  d.) 
Phvsical  or  mental  unfitness  for  the  position  is  deemed  good  cause  for  re- 
jection (I  251  (24)  h.)  (Art.  9.  Sec.  III.  and  art.  (24)  b.  Sec.  V.  Regulations 
governing  appointments  to  Navy  Yard  Service.     Exec,  order,  Dec.  7,  1912.) 

2143.  Applicants  for  employment  in  the  occupations  embracpd  m  group  1 
(laborers,  etc.)  will  be  placed  on  the  eligible  list  in  the  order  of  the  averages 
given  to  them  on  their  physical  ability  upon  a  physical  examination  which 
requires  a  strength  test.  (Instructions  to  applicants  for  employment  at  navy 
yards  and  naval"  stations.  Sec.  IV,  Form  2012,  January,  1913.) 

2144.  Application  Form  No.  1642  of  the  Civil  Service  Commission  shall  be 
used  for  examinations  for  positions  in  group  I.  The  examination  for  positions 
in  this  group  will  be  given  by  a  surgeon  or  physician  detailed  to  the  labor 
board  for  the  purpose.  Where  two  or  more  receive  the  same  average  percentage 
priority  shall  be  determined  by  the  time  of  filing  completed  application  (day, 
hour,  and  minute). 

2145.  The  hishest  rating  given  to  male  unskilled  laborers  is  98  per  cent, 
and  for  defects,  etc.,  thev  will  be  marked  down  from  1(X)  in  multiples  of  5  to 
70  per  cent,  all  helow  70  "being  marked  "  rejected."  Under  the  regulations  only 
those  rated  at  85  per  cent  or  more,  including  persons  entitled  to  preference 
under  .section  1754,  R.  S..  will  have  their  names  placed  upon  the  register  of  eli- 
gibles  A  man  rated  at  98  per  cent  must  weigh  not  less  than  160  pounds,  must 
be  of  corresponding  stature  (at  least  5  feet  6  inches),  and  must  be  able  to  lift, 
shoulder,  and  easilv  carry  a  mail  sack  and  contents  weighing  125  pountls.  He 
must  be' free  from"  phvsical  defects,  organic  and  functional,  and  in  such  gen- 
eral condition  of  vigor  and  health  that  there  is  a  reasonable  prospect  of  his 
being  useful  to  the  Government  for  20  years.  The  examination  should  not  be 
proceeded  with  in  the  case  of  an  applicant  who  fails  to  place  the  sack  upon  his 
shoulder  he  being  rejected  without  further  action.  Preference  will  be  given 
to  men  who  are  heavier  than  the  average,  provided  the  chest  expansion  Is 
norm.il  and  waist  measure  not  excessive.  Boys  are  not  required  to  stand 
the  Aveight-lifting  test.  .         .         .    ^,. 

2146.  In  case  of  female  applicants,  the  highest  rating  given  is  95  per  cent. 
The  txamination  is  of  a  modified  character  and  the  test  of  strength  is  omitted. 
An  examination  of  the  tlioraeie  contents  will  be  the  princiiial  feature,  together 
with  Questions  and  inspection  after  weighing  and  measuring. 

2147.  From  the  maximum  rating  in  either  sex  deductions  will  be  iiia<le  for 
anv  defect— e  g.,  obesity,  insufllcient  muscular  development,  deficient  chest 
mobility,  spinal  curvature,  pigeon  breast,  loss  of  one  or  more  fingers  or  toes 
or  portions  thereof,  defective  sight  or  hearing,  functional  defwts  of  cardiation, 
re.si)iration,  or  circulation,  etc. 

2148.  Tlie  following  are  causes  for  absolute  rejection:  Serious  impairment 
of  visioii  or  bearing;  dwided  cachexia;  tuberculosis;  venereal  disease;  perma- 
nent defects    (unless  slight)    or  loss  of  limb;   impalrefl  function  of  brain  or 


MANUAL  FOR   THE    MEDICAL  DEPARTMENT,  U.    S.    NAVY. 


149 


«^no,.«v  nnrnlvsis-  insanity;  chronic  otitis;  chronic  ulcers;  organic 
jSs^ar;nronr?oriraT,r?V'CSiaVshor!en''.he  period  of  ex- 

Sits"'Sr^^S£ris  >n  v>ew     A  .ef«t  ^e„«ooe.^a^s  a_cau^^ Jor 
rS'™hS°Lcdr"onfot'tSI  Sass  me™Jned  ma/be  li.e.y  to  develop  into  a 

SKed  S'l'e?r.aili?ra„5°m';;r£  sSinVen.ered  above  o.be,:.  in  oases 
•"^llSll'V  Tbffublects  and  weights  of  the  examlaatioa  for  positions  in 
groups  11,  III.  IV,  and  V  (a)  shall  be: 

Phvslcal  ability,  weight  4,  and 

Training  and  experience,  weight  6. 

%r;nst™Ss'°l^r"ratfn7pVsto\    aW'lW:  Applicants  for  all  noneduca- 

r'S9srVnS^itVo'n^^A^o^xLS''br.T^^^^^^ 
SSaSsr^rter^ne^tS^^^^ 

tfclble  be  execu  ed  by  one  of  the  commission's  designated  physicians 

S  "iaisr  sO  T^  ifporthTfoiirrta^ror^Sitfa^d 

weights : 


Height. 


5feet 

5  feet  1  inch 

5  feet  2  inches . . 
5 feet  3  inches.. 
5  feet  4  inches . . 

5  feet  5  inches . . 

6  feet  6  inches . . 
5 feet  7  inches.. 
5 feet  8  inches.. 
5feet9in:'hes.. 
5  feet  10  inches. 

5  feet  11  inches. 
6feet 

6  feet  1  inch  — 
6  feet  2  inches . . 
6  feet  3  inches . . 


Weight. 


Pounds, 
120  to  144 
122  to  147 
124  to  151 
127  to  154 
131  to  158 
134  to  163 
138  to  168 
142  to  174 
146  to  179 
150  to  185 
154  to  191 
159  to  198 
165  to  204 
170  to  208 
176  to  215 
181  to  224 


Per  cent. 


95 
95 
95 
95 
95 
95 


w^icrht  in  fractions  of  an  inch,  if  one-half  or  over,  should  be  rated  at  next 
hiS^nteger;  if  under  one-half,  next  lower,  except  to  receive  the  maximum 

^^t'^!S^'S<^^eX<^e^^T^  the  medical  certificate  s,/ 
normal  condVtifns;  applicants  whose  measurements  are  disproportionate,  but 


150        MANUAL   FOK   THE   MEDICAL  DEPAETMENT,   U.    S.    NAVY. 

who  are  otherwise  normal,  are,  if  over  5  feet  6  inches,  to  be  rated  at  95,  and  if 
under  at  90,  except  In  cases  of  well-marked  obesity,  or  underweif,'ht.  when  an 
additional  5  per  cent  may  be  deflucted,  making  the  former  rating  90,  the  latter 
85.  Tlie  maximum  rating  (9S)  should  not  be  given  an  applicant  whose  waist 
measure  equals  or  exceeds  tlint  of  his  chest  at  forced  expiration,  or  whose 
chest  mobility  is  less  than  3  inches. 

2154.  Deductions  will  be  made  for  any  defect  as  diminutive  physique,  spinal 
curvature,  obesity,  rupture,  defective  vision  or  liearing,  organic  dise.Tses,  de- 
formity, loss  of  hand  or  foot,  etc.  First,  the  measurements  of  the  applicant 
are  to  be  considered  and  a  tentative  rating  determined  from  them.  Having 
determined  what  the  normal  man  of  the  given  ilimenslons  would  receive  as  a 
rating  thereon,  the  further  statements  of  the  certificate  will  be  examined 
and  deductions  made  for  abnormalities  as  found  therein.  The  following  list 
comprises  the  more  common  existing  disabilities,  with  their  corresponding 
deductions : 

Contagious  or  infectious  diseases  (including  venereal).     Reject. 

Heart  disease,  except  in  cases  with  valvular  lesions  when  the  latter  are  fully 
comi)ensated,  as  attested  by  certificate  of  two  physicians.     Reject, 

Tuberculosis.     Reject. 

Epilepsy.     Reject. 

Insanity.     Reject. 

Blindness.     Reject. 

Loss  of  both  arms  or  both  legs.     Reject. 

Loss  of  arm  and  leg.     Reject. 

Locomotor  ataxia.     Reject. 

Cancer.     Reject. 

Right's  disease.     Reject. 

Diabetes.     Reject. 

Loss  of  hand  or  foot.     Deduct  35  or  more. 

Hernia  (rupture).     Deduct  from  .T)  to  rejection. 

PMes,  fistula,  or  fissure.     Deduct  from  15  to  rejection. 

Arterial  sclerosis   (hard  arteries).     Deduct  35. 

Spinal  curvature.     Deduct  from  15  to  35. 

Loss  of  finger  or  toes.     Deduct  from  15  to  35. 

Loss  of  eye.     Deduct  15. 

Deformities,  old  fractures,  etc.     Deduct  from  15  to  50. 

Varicocele.     Deduct  from  5  to  10. 

Varicose  veins.     Deduct  from  5  to  35. 

Minor  defects  of  vision.     I>educt  from  5  to  10. 

Skin  diseases  (noncontagious).     Deduct  from  5  to  25. 

Middle  ear  disease  or  deafness.     Deduct  15. 

Deficient  chest  mobility.     De<luct  from  5  to  10. 

Insufilcient  muscular  development.     Deduct  from  5  to  10. 

Obesity.     Deduct  from  5  to  10. 

Valvular  disease  of  heart  fully  compensated  as  attested  by  certificate  of  two 
nhvsicians.     Deduct  10. 

Enlarged  heart  (unaccompanied  by  valvular  disease).     Deduct  from  10  to  25. 

Irregiilar  lieart.     Deduct  from  10  to  25. 

Too  rapid  heart.     Deduct  from  5  to  10. 

Chronic  bronchitis.     Deduct  from  5  to  25. 

Clironic  tonsilitls  or  pharyngitis.     Deduct  from  5  to  15. 
Deviation  of  n:isal  septum,  cleft  palate,  etc.     Deduct  from  5  to  10. 
Chronic  disorders  of  stomach  or  bowels.     Deduct  from  10  to  50. 
Rheumatism  or  history  of  it.     Deduct  from  5  to  50. 

The  above  is  Intended  as  an  outliJio  of  tlie  method  of  drawing  conclusions 
from  the  medical  certificate  or  the  inlormaLlon  furnished  in  the  application, 
the  rating  being  largely  a  m.itter  of  uniform  interprelatlon  of  the  statements  as 
thev  bear  upon  tlie  potential  u.sefulncss  of  the  applicant  in  the  service. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        151 

A  rating  of  at  least  70  per  cent  on  physical  ability  will  be  requirea  of  all  ap- 
plicants for  employment  in  the  navy-yard  service  in  positions  filled  through 
noneducational  examination ;  otherwise  the  applicant  will  be  rejected. 

2155.  Discharged  employees  entitled  to  entry  of  name  on  general  list  shall  be 
rated  on  experience  and  physical  ability.  The  rating  for  experience  shall  be 
determined  by  averaging  the  percentage  ratings  based  on  marks  given  on  dis- 
charge card,  workmanship  having  a  weight  of  7  and  conduct  a  weight  of  3.  The 
rating  on  physical  ability  shall  be  that  given  the  applicant  on  his  application 
for  original  entrance  if  the  medical  certificate  was  executed  within  six  months; 
otherwise  a  new  rating  for  physical  ability  shall  be  made  on  basis  of  a  medical 
certificate  executed  by  the  yard  surgeon.  Experience  will  be  weighted  at  60 
per  cent  and  physical  ability  at  40  per  cent,  precisely  as  in  examinations  for 
original  entrance. 

Skction  10.— Naval  Instbuctions  Relating  to  Physical  Examination  Rk- 

QUIRED   UnDEK   the   COMPENSATION   ACT    (EmPLOYEK'S   LIABILITY   ACT)    OF   MaY, 

30,  1908.  ' 

2160.  Forms  used  for  reports  of  injury.  Navy  Department  letter.  May  26, 
1917.     G.  A.  1,  C.  A.  2,  C.  A.  4. 

2161.  Authorization  of  compensation  for  injury,     1391  (1)  a. 

2162.  Compensation  to  dependents  upon  death.     I  391  (1)  &. 

2163.  Report  of  death   from   injury.     1391  (1)  c. 

2164.  Affidavits  upon  death  oc  injury.     I  391  (1)  d. 

2165.  Medical  examinations,     1391  (1)  e. 

2166.  Payments  under  act.     1391  (1)  /. 

2167.  United  States  not  exempt  from  liability,     I  391  (1)  g. 

2168.  Payments  of  compensation  for  injury.     1391  (2). 
216J).  Injury  to  eyes,     1392  (1-5). 

2170.  Letter  for  guidance  of  medical  otficers,     I  393. 

Section   11, — General  Instructions   Relating  to  Compensation   or  United 

States  Employees, 

2171.  The  act  approved  September  7,  1916,  created  the  United  States  Em- 
ployees' Compensation  Commission  to  adjudge  compensation  for  injuries,  dis- 
ability, or  death  incurred  in  the  course  of  their  employment  to  United  States 
employees.     This  act  provides  that: 

No  compensation  shall  be  paid  if  the  injury  or  death  is  caused  by  the  willful 
misconduct  of  the  employee  or  his  intention  to  bring  the  injury  or  death  on 
himself  or  another,  or  if  intoxication  is  the  proximate  cause  of  the  injury  or 
death. 

That  during  the  first  three  days  of  disability  the  employee  shall  not  be 
entitled  to  compensation  except  as  provided  in  section  9.  No  compensation 
shall  at  any  time  be  paid  for  such  period.  (Sec;  9.  That  immediately  after 
an  injury  sustained  by  an  employee  while  in  the  performance  of  his  duty, 
whether  or  not  disability  has  arisen,  and  for  a  reasonable  time  there- 
after the  United  States  shall  furnish  to  such  employees  reasonable  medical, 
surgical,  and  hospital  services  and  supplies  unless  he  refuses  to  accept  them. 
Such  services  and  supplies  shall  be  furnished  by  United  States  medical  officers 
and  hospitals,  but.  where  this  is  not  practicable,  shall  be  furnished  by  private 
physicians  and  hospitals  designated  or  approved  by  the  commission  and  paid 
for  from  the  employees'  compensation  fund.  If  necessary  for  the  securing  of 
proper  medical,  surgical,  and  hospital  treatment  the  employee,  in  the  discretion 
of  the  commission,  may  be  furnished  transportation  at  the  expense  of  the 
employees'  compensation  fund.) 

That  if  at  the  time  the  disability  begins  the  employee  has  annual  or  sick 
leave  to  his  credit  he  may.  subject  to  the  approval  of  the  head  of  the  depart- 
ment, use  such  leave  until  it- is  exhausted,  in  which  case  his  compensation  shall 
begin  on  the  fourth  day  of  disability  after  the  annual  or  sick  leave  has  ceased. 


152        MANUAL  FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

Every  employee  injured  in  the  performance  of  his  duty,  or  some  one  on 
his  behalf,  shall,  within  48  hours  after  the  injury,  give  written  notice  thereof 
to  the  immediate  superior  of  the  employee. 

After  the  injury  the  employee  shall,  as  frequently  and  at  such  times  and 
places  as  may  be  reasonably  required,  submit  himself  to  examination  by  a  medi- 
cal officer  of  the  United  States  or  by  a  duly  qualilied  physician  designated  or 
approved  by  the  commission. 

In  ca.se  of  aiiy  disagreement  between  the  physician  making  an  examination 
on  the  part  of  the  United  States  and  the  employee's  physician  the  commission 
shall  appoint  a  third  physician,  duly  qualified,  who  shall  make  an  examination. 

2172.  The  department  in  circular  letter  of  February  10,  1909,  directed  com- 
mandants of  navy  yards  to  require  medical  officers  on  duty  at  yards  to  examine 
all  cases  of  injury  of  employees  coming  under  the  provisions  of  the  compensa- 
tion act  of  i\Iay  30,  1908,  when  required  to  do  so  by  the  oflicial  who  is  re<]uired 
to  certify  on  Form  C.  A.-4  that  the  applicant  has  been  physically  unable  to 
resume  his  work  by  reason  of  disability  arising  from  the  injury  for  which  com- 
pensation is  claimed. 

2173.  Civil  employees  at  navy  yards,  naval  stations,  and  naval  reservation.-;, 
when  sick  or  injured,  may  be  removed  to  their  homes  or  to  a  civil  hospital  by 
Government  conveyance  when  the  distances  involved  are  not  so  great  as  to 
embarrass  the  ambulance  service  or  unduly  involve  other  Government  trans- 
portation. Otherwise  any  expenses  for  such  transportation  must  be  borne  by 
the  employees.     (I  3411  (1).) 

2174.  Such  employees  may  be  cared  for  Jn  a  naval  hospital  when,  in  the 
opinion  of  the  medical  officer,  removal  to  their  homes  or  to  other  hospitals 
might  jeopardize  their  lives.  The  stay  of  such  patients  in  naval  hospitJils  shall 
continue  only  so  long  as  may  be  necessary  to  provide  for  their  transfer  home  or 
to  a  civil  hospital  without  endangering  their  prospects  of  recovery  as  regards 
life,  and  while  so  under  treatment  they  shall  be  required  to  pay  50  cents  for 
each  day  or  part  of  a  day,  all  money  so  received  to  be  applied  to  the  naval 
hospitiil  fund.     (I  3411   (2).) 

2175.  The  medical  officer  at  a  navy  yard  examining  injureti  civil  employees 
upon  request  of  the  head  of  department  should  make  a  record  of  all  facts  con- 
nected with  the  injury,  in  order  to  furnish  the  data  required  in  the  reports 
prescribefl  under  the  provisions  of  the  law.  The  following  represent  the  usual 
reports : 

(a)  C.  A.  1  notice  of  injury,  to  l>e  submitted  to  United  States  Employees' 
Compensation  Commission  by  every  employee  injured  in  performance  of  his 
duty,  or  some  one  on  his  behalf,  within  48  hours  after  injury.  This  notice  sliall 
be  given  by  delivering  it  personally  to  the  officinl  superior  or  by  depositing  it  in 
the  mail  properly  stamped  and  addressed  to  the  official  superior. 

(b)  C.  A.  2  report  of  injury,  to  be  submitted  as  soon  as  possible  after  injury 
by  the  reporting  officer. 

(c)  C.  A.  4,  claim  for  compensation,  to  be  filed  with  official  superior  within  GO 
days  after  injury  causing  disability  for  more  (ban  three  days.  This  claim 
must  be  subscribed  and  sworn  to  by  applicant  and  also  by  the  medical  officer 
of  the  station  where  the  injury  was  received  and  by  the  physician  who  iittended 
the  claimant.  There  is,  in  conclusion,  a  certificate  for  signature  by  the  official 
superior. 

217(5.  During  the  semiannual  examination  of  civil  employees  required  \inder 
the  net  it  shall  be  the  duty  of  the  medical  officer  to  record  any  disability  which 
might  at  a  subsiniuent  flatc  l)c  allegwl  to  be  the  result  of  accidental  injury  wliile 
engaged  In  Government  work. 


CHAPTER  13. 


THE  HEALTH  RECORD,  NOMENCLATURE,  JOURNAL  OF  THE  MEDICAL 
DEPARTMENT,  AND  REPORTS  OF  DEATH. 

Section  1. — Navy  Regulations  Relating  to  Health  Records. 

2201.  Patients  transferred  to  have  health  records.    R  2961  (2)  ;  R  3585  (1)  a. 

2202.  Entry  to  be  made  in  health  record  of  men  examined  before  transfer. 
R  2961  (3) ;  R  3581  (5). 

2203.  Date  of  transfer  to  other  than  a  naval  hospital  to  be  noted  in  health 
record.     R  2962  (1). 

2204.  Health  records  of  patients  left  in  foreign  hospitals  to  be  left  with 
consul.     R  2962  (2). 

2205.  Health  record  continued  by  medical  officer  of  any  ship  arriving  in 
port.     R  2962  (3). 

2206.  Junior  medical  officer  to  write  up  health  records.     R  2977 ;  I  3251. 

2207.  Not  in  line  of  duty  entries  on  health  record.     R  2902  (1-5). 

2208.  Disabilities  of  men  enlisted  to  be  entered  on  health  records.     (I  3209)  ; 
R  3523  (3).  ; 

2209.  Accidents  and  injuries  occurring  in  absence  of  medical  officer  to  be 
noted  on  health  record.     R  4563. 

Section  2. — Naval  Instructions  Relating  to  Health  Records. 

2211.  Custody  of  officers'  health  records.     1708  (1). 

2212.  Every  officer  required  to  notify  medical  officer  of  transfer.     1708  (2). 

2213.  Health  records  to  senior  officer  of  board  for  physical  examination. 
I  708   (3). 

2214.  Health  records  upon  completion  of  examination.     1708  (4). 

2215.  Health  records  M'here  no  medical  officer.     1708  (5). 

2216.  Officer  on  duty  where  no  medical  officer  to  furnish  reports  of  disa- 
bility.    I  70S  (6). 

2217.  Periodical  physical  exercises.     1709. 

2218.  Entries  in  health  records  indicating  use  of  intoxicants,  etc.    1707  (5). 

2210.  Health  records  to  be  inspected  by  fleet  surgeon.    1 1122  (2). 

2220.  Health  records  to  be  verified.     12102. 

2221.  Health  records  of  patients  received  for  passage.     12116. 

2222.  Medical  officers  shall  keep  health  records.     12117  (1). 

2223.  Completed  records  to  go  to  Bui'eau  of  Medicine  and  Surgery.    I  2117  (2) . 

2224.  Commanding  officer  to  inspect  health  records.     12619  (2). 

2225.  Entries  upon  enlistment  and  transfer.    I  3208  (1-2). 

2226.  Record  of  vaccination  to  be  entered  on  health  record.     13211  (1). 

2227.  Administration  of  typhoid  prophylaxis  to  be  entered  on  health  record. 
I  3212. 

2228.  Health  records  at  hospitals  to  be  examined  weekly.     I  3226. 

2229.  Patients  upon  admission  to  hospitals  to  have  health  records.    I  3229. 

2230.  Health  records  to  be  signed  and  verified.     13237. 

153 


154        MANUAL   FOR  THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

2231.  Care  in  keeping  iiealtli  records.     I  3252. 

2232.  Health  records  to  be  opened  upon  appointment  or  promotion  of  ofTicer. 

I  3257. 

2233.  Examination  of  enlisted  men  for  rating  of  fireman  to  be  entered  on 
healtli  records.     (Letter  Nav.  2158-249,  Feb.  24,  1912.) 

2231.  Records  of  physical  examinations  of  officers  for  periodical  physical 
exercise  in  January  to  be  made  in  healtli  records.    I  709  (5)  ;  I  708  (3). 

2235.  Naval  Reserve  Force.  R  4G53  (b)  ;  I  5507  (b)  ;  I  5509;  General  Orders, 
Nos.  231  and  237. 

Section  8. — Instructions  to  be  Observed  in  Opening  and  Preparing  Health 

Records, 

2241.  (c)  The  whole  name  (Christian,  middle,  and  .surname)  to  correspond 
with  that  on  service  record  and  to  be  legibly  written  out.  without  abbreviations, 
and  correctly  spelled,  preference  being  given  to  the  original  spelling  of  foreign- 
ers' names,  the  surname  to  precede  and  to  be  distinguished  by  being  underlined. 

(b)  As  far  as  possible,  on  reports  and  returns,  the  grades  and  rates  of 
officers  and  men  should  be  spelled  out  in  full,  but  where  sufficient  space  is  not 
provided  the  following  abbreviations  should  be  used : 

officers. 

Admiral  Adinr,  VAd,  or  RAd. 

Captain "(U?  S.  n')"~-I Capt. 

Commander Comdr. 

Lieutenant  Commander ■ Lt-C. 

Lieutenant Lt. 

Lieutenant  (junior  grade) Lt-jg. 

Ensign Ens. 

Midshipman Mid-1.  etc. 

Medical  Director MDir. 

Medical  Inspector ^^^"^P\  .,  „.„ 

Surgeon ■^'^S-  ASurg,  PAS,  or  Surg 

Dental  Surgeon DentS. 

Pay  Director PDir. 

Pav  Inspector PInsp. 

Paymaster APay,  PAP,  or  Pay. 

Chaplain Sl^^V 

Professor  of  Mnthemntics PMath. 

Naval  Constructor ANCon  or  NCon, 

Civil  Engineer ACEng  or  CEng. 

Boatswain CBoat  or  Boat. 

Gunner Cl^^"'^  o^'  ^un. 

Machinist C|Mach  or  Mach. 

Carpenter CCarp  or  Carp. 

Sailmaker GSail  or  Sail. 

Pharmacist CPharm  or  Pliarm. 

Pav  Clerk CPayC  or  PayC. 

Brigadier  General  (U.  S.  U.  C.) BrGM. 

Colonel  (F.  S.  M.  C.) ColM. 

Lieutenant  Colonel  (U.  S.  M.  <'.) LtCM. 

Major  (U.S.  M.C.) MajM. 

Captain  (U.  S.  M.  C.) CapM. 

First  Liouloiiant  (T^.  S.  M.C.) 1-LtM. 

Second  Lieutenant  (  V.  S.  M.  C.)   2-LtM. 

Quartermaster  Clerk  (U.  S.  M.  C.) QrCM. 

Marine  Gunner  (U.  S.  M.  C.) MarQ. 


MANUAL   FOK  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        155 
SEAMAN   BRANCH. 

Mate -^late. 

Master-at-arms CMntA.  MatA-1,  etc 

Boatswain's  mate CBM.  BM-1,  etc. 

Gunner's  mate CGM,  GM-1.  etc. 

Turret  captain CTC,  TC-1,  etc. 

Quartermaster CQr,  Qr-1,  etc. 

Coxswain Cox. 

Seaman  gunner SeaG. 

Seaman Sea-1  or  Sea-2. 

Appentice  seamnn AS. 

ARTIFICER  BRANCH. 

Machinist's  mate CMM,  MM-1,  etc. 

Electrician CEl,  El-1,  etc. 

Carpenter's  mate CCM.  CM-1,  etc. 

Storelveeper CStkr.  Stlfr-1,  etc. 

Printer CPrint  or  Print-1. 

Water  t7nde7_"_""_V__" CWT  or  WT. 

Boilermalier Bmlir. 

Coppersmitli Csmtii. 

Sliipfitter Sfit-1  or  Sfit-2. 

Blaclvsraith Blks. 

Plumber  and  fitter P  &  F. 

Sailmaker's  mate SmM. 

Painter Ptr-1,  etc. 

Oiler <~>iler 

Fireman F-1,  etc. 

Shipwright Swrt. 

Sl'hX'IAI,    BRANCH. 

Yeoman CY.  Y-1,  etc. 

Pharmacist's  mate CPhM,  PhM-1,  etc 

Bandmaster Band 

Commissary  steward CCmS,  or  CmS 

First  musician ^ 1-Mus. 

Ship's  cook SC-1,  etc. 

Baker Bak-1,  or  Bak-2. 

Hospital  apprentice HA-1  or  HA-2. 

Musician Mus-1,  or  Mus-2. 

Bugler Bugler 

Landsman Lds. 

MESSMEN   BRANCH. 

Steward  to  C  in  C SCinC 

Cook  to  C  in  C CCinC 

Steward  to  commandant SConi 

Cook  to  commandant CCom 

Cabin  steward CabS 

Cabin  cook CabC 

Wardroom  steward WRS 

Wardroom  cook WRC 

Steerage  steward StS 

Steerage  cook StC 

Warrant  off.  steward WOS 

Warrant  off.  cook ^— — .__..-_- WOO 

Mess  attendant MsA-1 ,  etc  --i 

'■.■.7^Mifp;-i  -t-^/i'i/r  inn  lo  9ii;jr;(i  r.,r  i 


156        MANUAL  FOE   THE   MEDICAL  DEPABTMENT,   U.    S.    NAVY. 

MARINE  (enlisted). 

Sergeant  (all  grades) , Sergt. 

Corporal Corp. 

Private Pvt. 

Apprentice  marine ApM. 

Drummer Drum. 

Trumpeter : Trump, 

PRISONERS. 

Men  serving  a  sentence  under  a  general  court-martial  (not  those  awaiting 
trial)  should  be  noted  as  GCMP,  or  for  detentioners  Det-1,  etc.,  in  spaces  pro- 
vided for  ratings. 

(c)  p]nter  the  rating  in  which  actually  enlisted. 

(d)  Enter  the  name  of  the  place  where  enlisted. 

(e)  Enter  date  actually  enlisted  and  strike  out  the  term  not  to  be  used  as  not 
applying  in  the  case  of  the  man  under  consideration,  following  the  date  of 
enlistment. 

(/)  Enter  month,  day,  and  year  of  birth. 

(g)   Specify  city,  town,  or  other  locality  of  birth,  whatever  the  nationality. 

(h)   Enter  (from  recruits'  statement)  all  former  diseases  and  injuries. 

(t)   Give  former  occupation  or  occupations. 

{})  For  enlisted  persons  give  the  number  of  continuous-service  certificate, 
years  of  previous  service. 

{k)  Give  name  and  address  of  nearest  relative  or  friend. 

(l)   Enter  religion. 

(m)  Eyes:  Blue,  gray,  blue-gray,  yellow-gray,  hazel  (light  brown),  dark 
brown,  bicolored  (as  when  the  pupillary  border  is  of  a  different  color  from  rest 
of  iris)  ;  also  state  when  the  two  eyes  are  of  different  colors. 

(n)  Hair:  Flaxen,  sandy  (yellowish  red),  auburn  (reddish  brown),  brown 
(light,  dark,  or  very  dark),  black;  also  whether  thin,  bald,  straight,  curly,  or 
woolly. 

(o)  Complexion  is  not  to  be  described  as  simply  "light  "  or  "dark,"  but  the 
character  and  degree  shall  be  as  accurately  stated  as  possible;  as  complexion, 
pallid,  sallow,  fair  (only  when  decidedly  clear),  ruddy,  florid,  dark  (tawny,  sun- 
burnt, or  tanned),  very  dark  (.swarthy  or  dusky),  mulatto,  negro. 

(p)  Height  to  be  expressed  in  inches;  the  body  to  be  erect,  the  chin  neither 
elevated  nor  depressed,  the  feet  and  knees  touching,  legs  stiff,  and  arms  hanging 
perpendicularly. 

(g)  Weight,  body  nude,  or  allowance  made  for  clothing  worn.  Accuracy  of 
scales  to  be  ascertained  before  using. 

(»•)  Vision  to  be  expressed  as  a  fraction,  of  which  the  numerator  will  be  (he 
distance  at  which  Snellen's  20-foot  test  can  be  determined,  and  the  denomi- 
nator 20. 

(«)  Hearing  is  to  be  expressed  as  a  fraction,  of  which  the  numerator  will  be 
the  distance  in  feet  a  whispered  voice  can  be  heard,  and  the  denominator  15. 

(t)  Circumference  of  thorax  to  express  the  mean  of  the  greatest  circumfer- 
ence after  forced  inspiration  and  of  the  least  after  forced  expiration,  measured 
by  a  tapeline  horizontally  at  the  precise  level  of  the  nipples;  the  difference 
between  the  greatest  and  least  circumference  to  be  entered  as  expansion. 

(«)  Teeth  missing  or  useless  .shall  be  indicated  by  marking  the  dental  for- 
mida  as  noted. 

(v)  Remarks:  Note  any  prominent  physical  trait  not  inconsistent  with  bodily 
vigor  or  not  in  such  degree  as  to  constitute  cause  for  rejection — leanne.ss  or  the 
reverse;  liirsuteriess ;  slight  asynunetry  of  body  or  limbs,  knock-knees,  bowlegs, 
or  flat  feet;  peculiarities  of  teeth  and  genitalia;  slight  varicocele,  etc.  In  this 
connection  examiners  are  to  remember  that  imperfections  that  might  pa.ss  in  a 
man  should  reject  boys. 

(io)  Marks  and  scars  should  be  indicated  as  required  on  the  priutetl  outline 
figure. 

(x)  Enter  the  date  and  luiture  of  any  waiver  re<iuested. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT^  U.    S.    NAVY.        157 

(y)  Finally  sign  the  record  in  the  space  provided.  Corrections  made  subse- 
quent to  enlistment  to  be  entered  in  red  ink  and  initialed. 

2242.  This  record  shall  be  prepared  for  each  officer  and  enlisted  man  of  the 
Navy  and  Marine  Corps  and  for  members  of  the  Nurse  Corps. 

2243.  When  an  enlisted  man  is  given  a  warrant  or  is  commissioned  the 
medical  officer  under  whose  professional  care  the  individual  comes  is  charged 
with  opening  a  new  record. 

2244.  A  green  record  shall  be  opened  by  the  superintendent  of  the  Nurse 
Corps  for  each  nurse  when  appointed,  utilizing  such  entries  as  may  be  ap- 
propriate. 

2245.  No  health  records  are  to  be  opened  for  members  of  the  Naval  Auxiliary 
Service,  but  when  admitted  to  the  sick  list  by  a  naval  medical  officer  a  record 
of  the  case,  with  a  statement  as  to  the  origin  of  the  disability,  shall  be  kept  on 
medical  history  leaves  from  a  heilth  record,  coutinued  until  the  termination 
of  the  case,  and  then  forwarded  to  the  Bureau  of  Medicine  and  Surgery. 

2246.  The  medical  record  of  retired  officers  and  enlisted  men  shall  be  kept  on 
medical  history  leaves  from  a  health  record,  to  be  continued  until  the  termina- 
tion of  the  case,  and  then  forwarded  to  the  Bureau  of  Medicine  and  Surgery. 
Such  records  nmst  show  an  expression  of  opinion  as  to  whether  or  not  the  dis- 
ability is  traceable  to  service  on  the  active  list. 

2247.  Medical  histories  of  supernumeraries  not  belonging  to  or  connected 
with  the  naval  service,  such  as  natives  in  the  insular  possessions  (not  enlisted 
natives  in  insular  forces),  are  not  to  be  forwarded  to  the  bureau.  (See  par. 
2293.) 

2248.  This  record  is  to  be  in  the  custody  of  the  senior  medical  officer  of 
the  ship  or  station  to  which  the  individual  is  most  directly  attached,  who  is 
responsible  for  its  care,  continuance  during  the  term  of  service  of  the  indi- 
vidual, and  its  further  disposition. 

2249.  The  medical  history  leaves  are  for  entries  relative  to  the  medical 
record  only.  Each  leaf  is  to  be  numbered  consecutively  and  the  name  in  full 
of  the  individual  and  place  entered  thereon.  In  every  case  the  ship  or  station 
at  which  the  entry  is  made  must  be  evident.  Entries  may  be  typewritten,  but 
must  be  signed  by  the  medical  officer  by  whom  or  for  whom  entered.  The 
senior  medical  officer  shall  approve,  disapprove,  or  may  modify  all  entries  made 
during  his  term  of  duty  as  such. 

2250.  Entries  on  the  medical  history  shall  be  made  when  the  individual  is 
admitted  to  the  sick  list,  or  as  a  note  when  applying  for  treatment  for  a  dis- 
ability not  requiring  an  admission  to  the  official  sick  list,  and  where  such  dis- 
ability has  a  possible  bearing  on  the  future  claim  for  pension, 

2251.  When  appearing  before  a  board  involving  a  physical  examination  the 
medical  member  thereof  shall  cause  an  entry  to  be  made  of  the  findings  and 
recommendations  of  the  board. 

2252.  All  infections  of  a  venereal  nature  must  be  regularly  admitted  to  the 
sick  list,  if  only  for  record. 

The  appropriate  circular,  from  among  those  issued  by  the  Bureau  of  Medicine 
and  Surgery,  should  be  given  to  each  patient  suffering  from  a  venereal  disease. 

The  advisory  or  warning  circular  on  venereal  diseases  should  be  distributed 
to  the  crew  at  frequent  intervals,  especially  in  connection  with  periodic  in- 
struction on  personal  hygiene,  etc. 

2253.  (a)  The  administration  of  typhoid  prophylaxis  and  vaccinations  shall 
be  noted  or  stamped  under  "  Vaecinations "  and  in  the  "  abstract  of  health 
j-ecord,"  in  red  ink,  at  the  ship  or  station  where  the  procedures  are  begun  or 
completed. 

(b)  The  attention  of  all  medical  officers  is  called  to  the  impoi-tance  of  carry- 
ing out  with  great  care  the  instructions  relative  to  entries  of  vaccination  and 
the  administration  of  typhoid  prophylactic  on  the  health  records  of  all  officers 
and  men  receiving  such  treatment.  Failure  to  make  such  entries  on  the  health 
records  may  impair  military  efficiency  to  a  serious  degree.  (Bureau  M.  &  S. 
124527,  124680.) 


158        MANUAL   FOR   THE    MEDICAL    DEPARTMENT,   U.    S.    NAVY. 

2254.  The  medical  history  entries  shall  state  specifically  and  definitely 
whether  or  not  the  disability  for  which  the  patient  Is  admitted  to  the  sick  list 
was  incurred  in  the  line  of  dnty,  and  whether  or  not  it  was  the  result  of  his 
own  misconduct.  Under  no  circumstances  are  these  statements  to  be  omitted. 
Before  making  such  entry  the  medical  officer  shall  carefully  consider  the  Navy 
or  Marine  Corps  service  of  the  patient  and  all  obtainable  evidence  bearing  on, 
the  case,  and  all  circumstances  directly  or  remotely  connected  with  the  origin 
of  tlie  disability  shall  be  carefully  investigated.  The  time  and  place  of  occur- 
rence, the  dates  between  which  there  was  exposure  to  a  morbific  cause,  sliould 
be  given.  AVhetl\er  considered  to  have  originated  iu  the  line  of  duty  or  not  in 
the  line  of  duty,  state  all  facts  that  can  be  elicited,  distinguishing  between  the 
testimony  of  the  patient  and  that  of  any  other  witnesses  and  in  express  terms 
accentins  or  reiecting  such  testimony  and  the  renson  therefor. 

Strike  out  text  of  paragraph  2255  and  insert : 

Article  2902,  Regulations  for  the  Government  of  the  Navy,  directs  that 
1 1  )  meilical  oltirers  making  entries  in  the  health  record  or  on  reports  of  death 
or  reports  of  medical  survey  of  officers  ur  enlisted  men  of  the  Navy  or  Marine 
Corps  for  disease  or  injury  shall  state  specifically  whether  such  disease  or  in- 
jury was  received  in  the  line  of  duty  or  not  in  the  line  of  duty,  and  when  not 
in  the  line  of  duty  whether  the  disease  or  injury  is  the  result  of  his  own  iuteni- 
Ijerate  use  of  drugs  or  alcoholic  liquors  or  other  misconduct. 

(21  When  the  medical  officer  having  the  custody  of  the  health  record  of  an 
officer  or  enlisted  man  of  the  Navy  or  Marine  Corps  enters  on  such  record  that 
any  disability  for  which  such  officer  or  enlisted  man  is  adujitted  to  the  sick  list 
was  not  received  in  line  of  duty,  or  was  the  I'esult  of  his  own  intemperate  use 
of  drugs  or  alcoholic  liquors  or  other  misconduct,  it  shall  be  the  duty  of  such 
medical  officer  to  inform  the  patient  when  such  an  adverse  entry  is  made,  pro- 
vided the  condition  of  the  patient  does  not  make  such  action  inadvisable.  He 
sliall  inforna  the  connnanding  officer  at  the  same  time,  and  the  procedure  then 
shall  be  as  prescribed  in  paragraj^h  4. 

(3)  It  shall  likewise  be  the  duty  of  (he  senior  member  of  any  board  which 
makes  a  similar  adverse  record  relative  to  the  origin  of  any  disease  or  injury 
to  inform  the  individual  concerned  of  such  record.  In  the  case  of  a  board  of 
medical  survey  the  statenient  in  rebuttal  should  not  be  incorporated  in  the 
body  of  the  survey  but  forwarded  as  a  separate  paper. 

(4)  It  shall  then  be  the  right  of  such  individual  to  request  the  connnanding 
officer  to  have  entered  on  the  health  record  bearing  such  an  adverse  entry 
such  evidence  in  rebuttal  as  he  may  desire  to  present.  A  copy  of  such  entry 
and  evidence  shall  then  be  forwarded  to  the  Bureau  of  Medicine  and  Surgery 
for  filing. 

(.">)  In  the  event  of  the  condition  of  the  individual  being  such  as  to  render 
it  imiiracticable.or  inadvisable  to  inform  him  of  such  adverse  entry,  this  fact 
shall  lie  noted  on  his  health  reciu-d,  and  he  shall  be  so  informed  so  soon  as 
circumslances  permit,  such  action  being  noted  on  the  record  when  taken. 

(C)  In  the  even!  of  (he  death  of  a  iierson  in  the  naval  service  in  which  Ihc 
connnanding  officer  does  not  apiirove  of  llie  assigned  origin  of  the  l'a[al  illness 
or  injury  as  given  in  the  official  report  of  dealh,  it  shall  be  his  duty  to  indorse 
thereon  Ins  opinion  and  (lie  reasons  llierefor,  (he  report  being  (hen  forwarded 
lo  the  Bureau  of  Medicine  and  Surgery  for  (ile. 

(7)  In  the  case  of  an  olhcer  or  enlisled  man  of  the  Navy  or  Marine  Corps  in 
iictive  sei-vi<'e  abseiil  fi-om  duty  oi,  account  of  sickness  oi'  disease  resulling  from 
his  own  intemperate  use  of  drugs  or  alcoh<ilic  liquors  or  other  misconiluci,  when 
(he  connn.-niding  officer  and  medical  officer  are  in  accord  (he  en(ry  shall  lie  final. 
Slumld  the  commanding  officer  and  medical  oHicer  disagree,  the  former  will  call 
a  board  of  officers  <if  not  less  ihan  two  members,  on(!  of  whom  shall  be  a 
medical  officer,  to  leport  upon  and  make  reconnnendations  in  the  case.  The 
approval  liy  (he  commanding  oHicei-  of  (he  findings  oC  (his  board  shall  lie  final; 
but  it  the'connuiinding  officer  disaiiproves  (lie  fin<lings  of  (he  board  (he  liro- 
ceedings  will  be  lorwarded  for  (he  action  ot  the  next  higher  authority.  A  copy 
of  the  final  decision  in  the  case  will  be  entered  in  tlie  heallh  record. 

(5)  Whenever  an  officer  or  eidisted  man  of  the  Navy  or  Marine  Corps  in 
active  ser\ice  is  absent  from  duty  on  account  of  sickness  or  disease  resulting 
from  his  own  intemperate  use  .if  drugs  or  al.-oholic  liqmn's,  or  odier  misconduct, 
the  medical  officer  having  cognizance  of  the  case  shall  jirepare  and  forward  to 
the  commanding  officer  an,  adniission  ■  .Miscaiduct  report,"  and  upon  the  in- 
dividual being  disc'harged  to  duly  a  discharge  "  Misconduct  report."  In  the  case 
of  olficers  these  repcn-ts  sliali  be  forwarded  in  duiilicate,  one  for  the  commanding 
officer,  the  other  via  the  commanding  officer  to  the  officer  carrying  the  officer's 
accounts.  In  (he  case  of  enlisted  men  the  reports  shall  be  made  in  triplicate 
when  ne<'essary  and  forwarded  througli  the  (Mimniiinding  officer,  one  each  for 
the  commanding  ollicer  and  the  officer  carrying  the  man's  accounts,  and  the 
third  for  the  oHicer  having  custody  of  the  man's  enlistment  record. 


MANUAL   FOR   THE    MEDICAL  DEPARTMENT,   U.    S.    NAVY.        159 

from  the  service,  and  before  the  history  leaves  of  an  ofhcer  are  iorwanled  to 
the  bureau.  Should  the  individual  immediately  reenlist  the  abstract  should 
be  removed  from  the  old  record  and  appended  to  the  new  one.  Upon  the  re- 
ceipt of  information  of  reenlistment  the  Bureau  of  Medicine  and  Surgery  will 
forward  the  abstract  from  previous  health  records. 

2262.  The  health  records  of  officers  when  promoted  and  upon  termination 
of  service  shall  be  clo.sed  and  forwarded  to  the  bureau.  In  the  case  of  promo- 
tion the  medical  officer  closing  the  health  record  in  the  previous  grade  sliall 
at  once  complete  (enter  date  appointed)  the  opening  of  a  new  health  record 
in  the  grade  to  which  pi'omoted.  The  abstract  should  be  removed  from  the  old 
record  and  appended  to  the  new  one. 

22G3.  In  case  of  loss  or  destruction  of  this  record  the  medical  officer  will 
at  once  notify  the  Bureau  of  Medicine  and  Surgery  and  will  immediately  open 
a  new  record,  supplying  such  information  as  may  be  available.  Should  it 
occur  that  the  missing  record  is  subsequently  received  the  entries  should  be 
transcribed  or  the  additional  information  inserted  into  the  old  record.  Under 
no  circumstances  should  material  facts  in  the  medical  history  fail  to  be  re- 
coi'ded  owing  to  the  nonreceipt  of  the  individual's  record. 

2264:.  In  the  event  of  an  expedition  for  distant  service  where  for  any  reason 
it  is  inadvisable  for  the  individual  health  records  to  accompany  the  command, 
additional  history  leaves  should  be  inserted  between  the  covers  of  a  blank 
record  to  its  fullest  capacity.  The  individual  medical  histories  may  then  be 
kept  on  separate  sheets  to  be  subsequently  inserted  into  proper  records,  or  for- 
warded to  the  bureau  for  its  files. 

2265.  This  record  is  to  be  closed  on  the  date  and,  if  practicable,  at  the  place 
where  the  person  is  actually  attached  when  discharged  or  when  the  service  is 
terminated,  by  filling  the  indicated  entries.  Physical  defects  not  disqualifying 
for  reenlistment  should  be  entered  under  "Marks,  scars,  etc."  Upon  termina- 
tion of  service  this  record  is  forwarded  as  soon  as  practicable  to  the  Bureau  of 
Medicine  and  Surgery. 

2266.  When  transferred  from  the  ship  or  station  the  record  is  forwarded 
through  the  commanding  officer  to  the  medical  officer  of  the  ship  or  station  to 
which  transferred.  In  the  case  of  an  officer  or  enlisted  man  ordered  before  a 
board  involving  a  physical  examination  it  shall  be  forwarded  to  the  senior 
member  of  such  board  for  its  consideration,  the  entry  of  the  findings  and 
recommendations  of  the  board.  Upon  the  completion  of  this  physical  exnmina- 
tion  the  record  is  forwarded  (a)  to  the  medical  officer  of  the  ship  or  station 
to  which  assigned,  (&)  in  case  of  officers  uuassigned,  recommended  to  be 
granted  sick  leave,  or  to  appear  before  another  board,  or  other  contingency 
when  a  proper  destination  is  not  apparent,  to  the  Bureau  of  Medicine  and 
Surgery.  Also,  when  the  individual  is  ordered  to  duty  where  there  is  no 
medical  officer,  or  granted  leave,  or  otherwise  permanently  removed  from  the 
observation  of  the  medical  officer  having  custody  of  this  record,  it  shall  be 
forward?  \  to  the  Bureau  of  Medicine  and  Surgery,  with  a  statement  of  the 
reasons  therefor, 

2267.  A  record  of  dental  treatment  will  be  kept  on  a  sheet  to  be  inserted  in 
the  health  record  immediately  following  sheets  for  the  "Medical  history." 
This  sheet  will  be  entitled  "  Dental  record,"  and  will  contain  a  record  of  the 
condition  of  patient's  teeth  when  first  examined  by  a  dental  officer  and  a 
record  of  all  subsequent  dental  operations  and  treatment. 

2268.  When  a  patient  is  under  dental  treatment  the  dental  record  will  be 
detached  and  .sent  to  the  dental  officer  concerned.  Upon  completion  of  treat- 
ment the  dental  officer  shall  make  the  necessary  entries  over  his  own  signa- 
ture and  return  the  dental  record  to  the  medical  officer  having  charge  of  the 

2269.  Should  it  appear  necessary  to  admit  a  patient  to  the  sick  list  the 
dental  officer  will  report  the  circumstances  to  the  medical  officer  concerned, 
who  will  enter  the  case  on  his  records  in  the  customary  manner. 

2270.  Dental  officers  will  retain  an  abstract  of  all  dental  treatment  in  order 
to  make  a  quarterly  report  to  the  Bureau  of  Medicine  and  Surgery,  using  for 


158        MANUAL   FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

2254.  The  medical  liistory  entries  shall  state  specifically  and  definitely 
whether  or  not  the  disability  for  which  the  patient  is  admitted  to  the  sick  list 
was  incurred  in  the  line  of  duty,  and  whether  or  not  it  was  the  result  of  his 
(»wn  misconduct.  Under  no  circumstances  are  these  statements  to  be  omitted. 
Before  making  such  entry  the  medical  officer  shall  carefully  consider  ihe  Navy 
or  Marine  Corps  service  of  the  patient  and  all  obtainable  evidence  bearing'  on 
the  case,  and  all  circumstances  directly  or  remotely  connected  with  tlie  orij^in 
of  the  disability  shall  be  carefully  inve.stigated.  The  time  and  place  of  occur- 
rence, the  dates  between  which  there  was  exposure  to  a  morbitic  cause,  should 
be  given.  Whether  considered  to  have  orij:inated  in  the  line  of  duty  or  not  in 
the  line  of  duty,  state  all  facts  that  can  be  elicited,  distinguishing  between  the 
testimony  of  the  patient  and  that  of  any  other  witnesses  and  in  express  terms 
accentine  or  rejecting  such  testimony  and  the  reason  therefor. 

Strike  out  text  of  paragraph  2255  and  insert : 

Article  2902,  Regulations  for  the  Government  of  the  Navy,  directs  that 
'  1  »  medical  ollicers  making  entries  in  the  health  record  or  on  reports  of  death 
or  reports  of  medical  survey  of  officers  or  enlisted  men  of  the  Navy  or  Marine 
Corps  for  disease  or  injury  shall  state  specifically  whether  such  disease  or  in- 
jury was  received  in  the  line  of  duty  or  not  in  the  line  of  duty,  and  when  not 
in  the  line  of  duty  whether  the  disease  or  injury  is  tlie  result  of  his  own  intem- 
perate use  of  drugs  or  alcoliolic  liquors  or  other  misconduct. 

(2)  When  the  medical  ofticer  liaving  the  custody  of  the  health  record  of  an 
officer  or  enlisted  man  of  llie  Navy  or  Marine  Corps  enters  on  such  record  that 
any  disability  for  which  sucli  officer  or  enlisted  man  is  admitted  to  the  sick  list 
was  not  received  in  line  of  duty,  or  was  the  result  of  his  own  intemperate  use 
of  drugs  or  alcoholic  liquors  or  other  misconduct,  it  shall  be  the  duty  of  such 
medical  officer  to  inform  the  patient  when  such  an  adverse  entry  is  made,  pro- 
vided the  condition  of  the  patient  does  not  make  such  action  inadvisable.  He 
shall  inform  the  commanding  officer  at  the  same  time,  and  the  procedure  then, 
shall  be  as  prescribed  in  paragrsTph  4. 

(3)  It  shall  likewise  be  the  duty  of  (he  senior  member  of  any  Iniard  which 
makes  a  similar  adver.se  record  lelative  to  the  origin  of  any  di.sease  or  injury 
to  inform  the  individual  concerned  of  such  record.  In  the  case  of  a  board  of 
medical  survey  the  statement  in  rebuttal  should  not  be  incorporated  in  the 
body  of  the  survey  but  forwarded  as  a  separate  paper. 

(4)  II  shall  then  be  the  right  of  sudi  individual  lo  recjuesl   the  conmianding 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        159 

from  the  service,  and  before  the  history  leaves  of  an  officer  are  iorwarded  to 
the  bureau.  Should  the  individual  immediately  reenlist  the  abstract  should 
be  removed  from  the  old  record  and  appended  to  the  new  one.  Upon  the  re- 
ceipt of  information  of  reenlistment  the  Bureau  of  Medicine  and  Surgery  will 
forward  the  abstract  from  previous  health  records. 

2262.  The  health  records  of  officers  when  promoted  and  upon  termination 
of  service  shall  be  closed  and  forwarded  to  the  bureau.  In  the  case  of  promo- 
tion the  medical  officer  closing  the  health  record  in  the  previous  grade  shall 
at  once  complete  (enter  date  appointed)  the  opening  of  a  new  health  record 
in  the  grade  to  which  promoted.  The  abstract  should  be  removed  from  the  old 
record  and  appended  to  the  new  one. 

2263.  In  case  of  loss  or  destruction  of  this  record  the  medical  officer  will 
at  once  notify  the  Bureau  of  Medicine  and  Surgery  and  will  immediately  open 
a  new  record,  supplying  such  information  as  may  be  available.  Should  it 
occur  that  the  missing  record  is  subsequently  received  the  entries  should  be 
transcribed  or  the  additional  information  inserted  into  the  old  record.  Under 
no  circumstances  should  material  facts  in  the  medical  history  fail  to  be  re- 
coi-ded  owing  to  the  nonreceipt  of  the  individual's  record. 

2264.  In  the  event  of  an  expedition  for  distant  service  where  for  any  reason 
it  is  inadvisable  for  the  individual  health  records  to  accompany  the  command, 
additional  history  leaves  should  be  inserted  between  the  covers  of  a  blank 
record  to  its  fullest  capacity.  The  individual  medical  histories  may  then  be 
kept  on  separate  sheets  to  be  subsequently  inserted  into  proper  records,  or  for- 
warded to  the  bureau  for  its  files. 

2265.  This  record  is  to  be  closed  on  the  date  and,  if  practicable,  at  the  place 
whei-e  the  person  is  actually  attached  when  discharged  or  when  the  service  is 
terminated,  by  filling  the  indicated  entries.  Physical  defects  not  disqualifying 
for  reenlistment  should  be  entered  under  "Marks,  scars,  etc."  Upon  termina- 
tion of  service  this  record  is  forM'arded  as  soon  as  practicable  to  the  Bureau  of 
Medicine  and  Surgery. 

2266.  When  transferred  from  the  ship  or  station  the  record  is  forwarded 
through  the  commanding  officer  to  the  medical  officer  of  the  ship  or  station  to 
which  transferred.  In  the  case  of  an  officer  or  enlisted  man  ordered  before  a 
board  involving  a  physical  examination  it  shall  be  forwarded  to  the  senior 
member  of  such  board  for  its  consideration,  the  entry  of  the  findings  and 
recommendations  of  the  board.  Upon  the  completion  of  this  physical  ex°  mina- 
tion  the  record  is  forwarded  (a)  to  the  medical  officer  of  the  ship  or  station 
to  vs'hich  assigned,  (b)  in  case  of  officers  unassigned,  recommended  to  be 
granted  sick  leave,  or  to  appear  before  another  board,  or  other  contingency 
when  a  proper  destination  is  not  apparent,  to  the  Bureau  of  Medicine  and 
Surgery.  Also,  when  the  individual  is  ordered  to  duty  where  there  Is  no 
medical  officer,  or  granted  leave,  or  otherwise  permanently  removed  from  the 
observation  of  the  medical  officer  having  custody  of  this  record,  it  shall  be 
forwarde  \  to  the  Bureau  of  Medicine  and  Surgery,  with  a  statement  of  the 
reasons  therefor. 

2267.  A  record  of  dental  treatment  will  be  kept  on  a  sheet  to  be  inserted  in 
the  health  record  immediately  following  sheets  for  the  "Medical  history" 
This  sheet  will  be  entitled  "Dental  record,"  and  will  contain  a  record  of  the 
condition  of  patient's  teeth  when  first  examined  by  a  dental  officer  and  a 
record  of  all  subsequent  dental  operations  and  treatment. 

2268.  When  a  patient  is  under  dental  treatment  the  dental  record  will  be 
detached  and  sent  to  the  dental  officer  concerned.  Upon  completion  of  treat- 
ment the  dental  officer  shall  make  the  necessary  entries  over  his  own  si-^n  i- 
ture  and  return  the  dental  record  to  the  medical  officer  having  charge  of^tlic 

2260.  Should  it  appear  necessary  to  admit  a  patient  to  the  sick  list  the 
dental  officer  will  report  the  circumstances  to  the  medical  officer  concerned 
who  will  enter  the  case  on  his  records  in  the  customary  manner.  ' 

2270.  Dental  officers  will  retain  an  abstract  of  all  dental  treatment  in  order 
to  make  a  quarterly  report  to  the  Bureau  of  Medicine  and  Surgery,  using  for 


160        MANUAL  FOR   THE   MEDICAL   DEPARTMENT,  U.    S.    NAVY. 

this  purpose  the  special  sheet  of  Form  K.  This  sheet  will  be  forwarded  with 
the  statistical  report  (Form  K)  of  the  ship  or  station  to  which  the  dental 
ofllcer  is  attached.     (Par.  1037.) 

2271.  For  the  purpose  of  recording  operations  and  treatment  of  teeth  and 
the  keeping  of  dental  records  the  following  classification  of  the  teeth,  cavities, 
and  fillings  will  be  used 


(a)  Classification  of  teeth  : 

1.  Right  superior  third  molar. 

2.  Right  superior  second  molar. 

3.  Right  superior  first  molar. 

4.  Right  superior  second  l)icuspid. 

5.  Right  superior  first  bicuspid. 

6.  Right  superior  cuspid. 

7.  Right  superior  lateral  incisor. 
S.  Right  superior  central  incisor. 
9.  Tveft  superior  central  incisor. 

10.  Left  superior  lateral  incisor. 

11.  Left  superior  cuspid. 

12.  Left  superior  first  bicuspid. 

13.  Left  superior  second  bicuspid. 

14.  I^ft  superior  first  molar. 

15.  Left  superior  second  molar. 

16.  Left  superior  third  molar. 

(b)  Classification  of  surfaces: 
E.  External.  I  M.  Mesial 
I.    Internal.                                      I  D.  Distal 
O.  Occlusal. 


17.  Right  inferior  third  molar. 

18.  Uight  inferior  second  molar. 

19.  Right  inferior  first  molar. 

20.  Right  inferior  second  bicuspid. 

21.  Right  inferior  first  bicuspid. 

22.  Right  inferior  cuspid. 

23.  Right  inferior  lateral  incisor. 

24.  Right  inferior  central  incisor. 

25.  Left  inferior  central  incisor, 

26.  Letf  inferior  lateral  incisor. 

27.  Left  inferior  cuspid. 

28.  Left  inferior  first  bicuspid. 

29.  Left  inferior  second  bicuspid. 

30.  Left  inferior  first  molar. 

31.  Left  inferior  second  molar. 

32.  Left  inferior  third  molar. 


Example:  The  classification  of  cavities  is  effected  by  the  use  of  the  initial 
letter  of  the  surface.  2.5-E  would  indicate  a  simple  cavity  on  the  external  or 
labial  surface  of  the  left  inferior  central  incisor.  30-EIO  would  indicate  a 
compound  cavity  of  the  externo-interno-occlusal  surface  of  the  left  inferior  first 
molar. 

(c)  Classification  of  filling  material : 

Tin.  ]  Cem. :  Cement. 

Am!:  Amalgam.  I  Gp. :  Gutta-percha. 

Example :  14-E-Tiu  would  indicate  that  a  simple  cavity  on  the  external  or 
buccal  surface  of  the  left  superior  first  molar  had  been  filled  with  tin.  5-MO- 
Cem.  would  indicate  that  a  compound  cavity  of  the  niesio-occlusal  surface  of 
the  right  superior  first  bicuspid  had  been  filled  with  cement. 

(d)  Other  operative  procedures  should  be  written  in  full,  such  as  "abscess 
lanced,"  "calculus  removed,"  "gums  lanced,"  "pulp  capped,"  "pulp  devitalized," 
"  pulp  extirpated,"  "  root  canal  filled,"  "  tooth  extracted,"  "  tooth  treated,"  etc. 

Section  4. — Detailed  Directions  Reoahdtng  the  Health  Records  of  Enlisted 

Men. 

2281.  The  health  record  will  accompany  an  enlisted  man  throughout  his 
current  enlistment.  It  will  be  retained  by  the  medical  officer  of  each  ship  and 
station  to  which  the  man  may  be  attached,  juul  each  officer  will  be  responsible 
for  its  proper  care,  continuation,  and  further  disposition.  When  a  transfer  of  a 
Tnan  occurs  the  health  record  is  to  be  forwarded,  through  olUcial  channels,  to 
the  medical  officer  at  his  destination,  or,  if  this  is  impracticable,  to  the  medical 
officer  of  the  ship  or  station  where  llie  man's  service  record  is  kept.  Should  a 
transfer  to  hospital  be  required  prior  to  the  arrival  of  the  patient's  health 
record,  a  record  of  the  illness  may  be  made  on  loo.se  medical  history  sheets, 
stating  the  necessity  for  this  procedure,  and  transmitted  with  other  papers  to 
the  hospital,  pending  arrival  of  the  health  record  i)n)per.  Upon  terininaUon  of 
service  the  record  will  be  at  once  completed  by  making  the  proper  entries  and 
forwarded  to  the  Bureau  of  Medicine  and  Surgery.  The  medical  history  Is 
retained  for  the  bureau's  files  and.  In  case  of  reeiilistment,  the  "abstract  of 


MANUAL  FOR   THE   MEDICAL  DEPARTMENT,  U.    S,    NAVY.        161 

health  record  "  will  be  reissued,  to  be  appended  by  medical  officer  receiving  it  to 
the  new  health  record.  In  case  of  immediate  rcenlistment  the  abstract  is 
removed  from  the  old  record  and  inserted  in  the  new  record. 

2282.  If  a  record  is  lost  or  destroyed  a  new  one  is  to  be  opened  immediately 
by  the  first  medical  officer  aware  of  such  loss,  who  will  note  the  fact  and  con- 
tinue the  medical  history  from  that  date,  with  such  previous  data  as  may  be 
obtainable.  If  the  old  record  be  found  detach  all  history  from  the  new  and 
attach  it  to  the  old  record. 

2283.  As  the  medical  history  is  continuous,  care  must  be  taken  to  indicate 
the  uame  of  the  man  and  of  the  ship  or  station  on  each  sheet  to  which  sub- 
sequent entries  apply.  Daily  entries  of  the  progress  of  the  illness  are  not 
obligatory,  but  will  be  made  as  often  as  circumstances  require,  giving  concisely 
all  essential  details  regarding  symptoms,  course,  and  treatment.  All  facts 
relating  to  the  origin  of  disease  or  injury  should  be  noted,  and  if  a  conflicting 
opinion  is  subsequently  expressed  by  the  same  or  some  other  medical  officer  the 
reasons  for  such  change  must  be  fully  stated.  The  provisions  of  article  R  2902, 
Navy  Regulations,  shall  be  carefully  observed.  Continuance  or  absence  of  dis- 
ability will  be  stated  when  patient  is  discharged  to  duty  or  from  the  service. 

2284.  The  following  abbreviations  shall  be  used  on  the  left  margin  of  the 
medical  history  sheets: 


A,  admitted. 
RA,  readmitted. 
D,  discharge  to  duty. 
C,  diagnosis  changed. 


DD,  died. 

IS,  invalided  from  service. 

R,  ran  (deserted). 

T,  transferred. 


Note. — Abbreviations  used  in  the  margin  of  the  medical  history  sheets  of  the 
health  record  are  interpreted  as  follows: 

Admitted :  All  original  admissions. 

Readmitted :  Every  subsequent  admission  for  the  continuance  of  the  same 
disability.  When  a  patient  is  received  by  transfer  he  shall  be  taken  up  as  a 
readmission  with  the  disability  under  which  transferred. 

Discharged  to  duty:  All  cases  restored  to  duty.  Patients  granted  leave  of 
absence  to  begin  upon  discharge  from  treatment  shall  be  noted  as  to  duty  D. 

Diagnosis  changed :  When  a  change  of  diagnosis  is  required,  for  an  evidently 
erroneous  diagnosis,  the  manner  of  discharge  shall  be  indicated  by  the  letter  C. 
The  same  letter  shall  be  used  when  a  diagnosis  is  changed  by  reason  of  the 
intervention  of  another  distinct  disability,  provided  the  patient  has  not  recov- 
ered or  is  unlikely  to  recover  from  the  former  disability.  Examples:  (a)  A 
case  is  admitted  with  sprain  of  joint  and  is  later  determined  to  be  a  fracture ; 
discharge  as  C  and  admit  A  with  fracture.  ( 6 )  A  patient  under  treatment  for 
tuberculosis  receives  an  injury ;  discharge  as  C  and  admit  A  with  the  injury, 
then  when  considered  fit  in  all  respects  for  duty,  so  far  as  the  injury  is  con- 
cerned, discharge  to  duty  D  and  readmit  RA  with  tuberculosis.  If  for  any 
reason  a  termination  of  service  takes  place  by  death  or  survey  on  account  of 
tuberculosis  and  the  injury  remains  unhealed,  then  the  case  shall  show  the 
disposition  of  the  injury  as  C  and  readmission  RA  with  tuberculosis,  the  object 
being  to  show  that  termination  of  service  was  on  account  of  tuberculosis  and 
not  the  intercurrent  injury. 

Died:  Discharged  on  account  of  death.  Should  death  result  from  a  disability 
other  than  that  with  which  the  patient  is  carried  on  the  sick  list,  the  case 
should  be  disposed  of  as  C  and  admitted  A  with  the  direct  cause  of  death  and 
immediately  disposed  of  as  DD. 

Invalided  from  service :  Termination  of  service  of  an  enlisted  man  through  an 
approved  recommendation  of  a  board  of  medical  survey,  that  of  a  midshipman 
for.  physical  disability,  or  that  of  an  officer  placed  on  the  retired  list  by  reason 
of  physical  disability. 

Note. — Only  the  place  from  which  actually  discharged  from  the  service  shall 
use  this  disposition ;  e.  g.,  a  hospital,  station,  or  ship  surveys  a  man  and  recom- 
mends his  discharge  from  the  service,  but  the  actual  discharge  takes  place  on 
98601°— 17 11 


162        MANUAL   rOB   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 


a  receiving  ship  or  other  station ;  such  iiospital,  station,  or  ship  sliall  show  the 
disposition  of  this  case  as  transferred  T  and  the  place  to  which  transferred, 
(Shall  readmit  KA  the  case,  and  dispose  of  It  as  IS  on  the  date  Of  actual  dis- 
charge from  the  service. 

Ran:  Termination  of  service  through  desertion. 

Transferred:  ladicates  the  disposition  of  a  patient  to  another  place.  The 
same  designation  shall  be  used  to  Indicate  the  disposition  of  an  officer  dis- 
charged from  the  sick  list  and  ordered  to  appear  before  a  retiring  board  or  sent 
to  sick  leave,  also  patients  discharged  by  reason  of  expiration  of  enlistment 
while  on  the  sick  list. 

Patients  transferred  to  other  than  United  States  naval  institutions  shall  not 
be  discharged  from  the  sick  list;  they  shall  be  recorded  in  all  respects  as  though 
they  were  at  the  station,  yard,  or  on  board  the  ship  from  which  sent,  unless 
the  service  record  of  the  man  is  transferred  or  the  officer  detached,  in  which 
event  the  case  shall  be  disposed  of  T  and  the  health  record  forwarded  in  accord- 
ance with  instructions.  Cases  sent  to  or  received  from  other  than  United 
States  naval  Institutions  shall  at  once  be  reported  to  the  Bureau  of  Medicine 
and  Surgery  by  letter,  giving  the  name  in  full,  rate,  diagnosis,  and  date  trans- 

The  name  of  the  place  to  which  a  patient  is  transferred  shall  always  be 
clearlv  stated  on  all  Medical  Department  records. 

2285.  Trivial  affections  not  requiring  admission  to  the  sick  list  may  he  indi- 
cated by  a  note.    For  ordinary  cases  the  following  examples  indicate  the  data 
required : 
'itU  Ic  U.  S.  S.  Montma. 


A. 

D. 

2. 

Mote, 


A. 
T. 

.0, 


r. 
I, 
UA. 


D. 

!i2. 


June  10,  1910.    Tonsillitis,  acute  follicular.    Origin  in  the  line  of  duty  ; 

exposure  on  watch.    Mild  attack. 
June  12,  1910.    Well. 

June  19,  1910.    Wound  (lacerated),  scalp.    Injured  while  coaling  ship. 
Wound  sutured  and  dressed. 

O,  D.  Bbowne, 
Passed  Assistant  Surgeon,  U.  Si  N>.i    > 

■         .M,T 

July  20,  1910.    Hernia  (inguinal)  complete,  left.    Origin  in  the  line  of 

duty.    Hernia  reduced  and  retained  temporarily  by  splca  bandage. 
July  25,  1910,    To  Naval  Hospital,  Chols(»a,  Mass. 

A.  B.  Smith, 
AsHlAtdvf  Surgeon,  U.  S.Jf. 
Approv(?d. 

O.  D.  Jones, 

Purgeon,  V.  S.  .V. 

Naval  Hospitai.,  Chki,.sea,  Mass.    ( 
July  25,  1910.     Hernia    (Inguinal),  left.     Origin  not  in  line  of  duty,, 

Article   R   2902   complied   with.     According   to   patient's   accepted 

statement.  Injury  existed  prior  to  enlistment. 
July  28.  1910.    Basslnl  operation;  other  anesthesia;  no  complications. 

Patient  reacted  well  after  operation. 
August  10,  1910.     Convalescent. 
Au'j:ust  25,  1910.     Up  and  about. 
September  15.  1910.     Cure(L 


y'(7. 


E.  F.  Anukkws, 
,/   .{xnisfont  Surgeon,  U.  S.  N. 


Approved. 

G.  H.  PiiiiLi's, 

Medical  Dirrrtor,  V.  S.  N.,  in  Vomnuiiui. 


MANUAL   FOB  THE    MEDICAL  DEPARTMENT,   U.    S.    NAVY.        163 

2286.  No  forms,  reports,  photographs,  or  folded  papers  should  be  attached  to 
or  inserted  in  the  health  record.  In  the  case  of  medical  survey,  a  brief  entry 
will  be  made  of  the  board's  findings  and  recommendations.  Entries  should  be 
made  of  all  physical  examinations,  such  as  are  required  for  change  of  rating 
fi'om  seaman  branch  to  fireman  third  class,  for  aviation  duty,  for  diving,  for  use 
of  the  smoke,  helmet,  etc. 

2287.  To  prevent  breakage,  avoid  repeatedly  opening  the  metal  clips.  Slips 
must  not  be  removed  unnecessarily,  and  when  new  ones  are  attached,  provide 
enough  for  all  reasonable  requirements. 

2289.  The  health  record  of  an  insane  patient  accompanies  the  patient  and  is 
left  in  charge  of  the  institution  to  which  he  is  committed,  with  a  request  that  a 
concise  history  of  the  case  be  continued  therein.  If  a  medical  officer  of  the 
Navy  is  assigned  to  the  institution,  it  will  be  his  duty  to  care  for  such  records 
and  continue  the  case  histories  of  all  naval  patients.  The  medical  officer  of  the 
receiving  ship  or  barracks  at  Mare  Island,  Cal.,  where  service  records  are 
i'Ctained,  has  official  charge  of  the  health  records  of  insane  patients  at  a  State 
hospital.  He  should  request  information  regarding  the  condition  of  patients 
from  time  to  time  in  order  to  make  necessary  entries,  and  upon  discharge  or 
transfer  close  the  record  and  forward  it  to  the  bureau. 

2290.  If  for  any  reason  it  becomes  necessary  to  forward  a  health  record  to 
the  bureau  other  than  for  termination  of  service,  it  shall  be  accompanied  by  a 
letter  stating  the  reason. 

2291.  In  the  cases  of  stragglers  declared  deserters  subsequently  surrendering,, 
the  health  record  will  be  returned  from  the  bureau  upon  request.  In  the  cases 
of  stragglers  from  other  ships  or  stations,  the  health  record  should  be  requested 
and,  until  its  receipt,  any  medical  history  should  be  entered  on  loose  leaves  for 
subsequent  insertion  into  the  record. 

2292.  For  enlisted  men  or  marines  to  be  embarked  on  an  Army  transport,  if 
jiot  provided  with  them,  health  records  should  be  opened  and  entries  of  vaccina- 
tions made. 

2293.  Upon  the  admission  of  a  supernumerary  a  medical  history  sheet  from 
a  health  record  shall  be  opened  and  kept  as  prescribed  for  enlisted  men.  When 
discharged,  such  histories  should  be  forwarded  to  the  bureau,  and  in  case  of 
the  death  of  a  supernumerary,  a  death  report  shall  be  forwarded.  (See  par. 
2247.)  In  cases  of  rejection  of  an  applicant  for  enlistment  whose  admission 
to  hospital  for  removal  or  cure  of  disqualification  is  recommended,  a  record 
shall  be  kept  on  medical  history  leaves  and  forwarded  to  the  bureau  if  the 
candidate  is  not  finally  enlisted.  If  enlisted,  such  record  should  be  embodied 
in  a  health  record. 

2294.  In  the  case  of  a  man  extending  his  enlistment,  his  health  record  shall 
be  continued  until  the  service  covering  the  extension  has  terminated.  Every 
man  extending  his  enlistment  must  pass  the  same  physical  examination  as  is 
required  for  reenlistment  and  be  vaccinated.     (Sec.  2086  (c).) 

2295.  When  men  are  tran.sferred  to  the  Fleet  Naval  Reserve  (class  1  (c) 
or  (d))  their  health  records  in  the  regular  service  shall  be  closed  by  noting  on 
the  page  under  "  Termination  of  service  "  all  the  entries  and  stating  "  By  reason' 
of"  transfer  to  Fleet  Naval  Reserve,  class  1  (c)  or  (d),  as  the  case  may  be. 

The  descriptive  list  and  abstract  of  health  record  should  be  copied  in  a  "new 
health  record  and  the  old  one  then  forwarded  to  the  Bureau  of  Medicine  and 
Surgery  and  the  new  one,  marked  on  its  face  "  Fleet  Naval  Reserve,"  forwarded, 
as  required,  to  the  commanding  officer  of  the  recrniting  district  concerned. 

2296.  Upon  the  granting  of  a  furlough  without  pay,  as  authorized  by  the 
act  of  August  29,  1916,  note  showing  action  should  be  made  on  the  sheet  used 
for  closing  health  record  and  signed  by  the  medical  officer.  The  current  health 
record  should  then  be  forwarded  to  the  Bureau  of  Medicine  and  Surgery.  A 
copy  of  the  descriptive  list  (first  page  of  health  record)  should  be  made'  and, 
together  with  the  "Abstract  of  health  record,"  forwarded  to  the  place  where 
the  iiervice  record  Is  sent.     (Gen.  Ord.  No.  231.)  ■' 


164        MANUAL   FOR   THE    MEDICAL  DEPAETMENT,   U.    S.    NAVY. 

2297.  New  health  records  will  be  opened  for  all  officers  and  enlisted  men. 
Where  Navy  health  records  have  been  adopted  as  "  State  health  records,"  a 
copy  of  entVies  in  the  vaccination,  typhoid  prophylactic,  and  dental  records, 
and  in  the  ub.stract  of  health  record,  will  be  entered  in  the  proper  places  in  the 
new  health  record.  The  State  health  record  will  be  closed  and  forwarded  to 
the  Division  of  Naval  Militia  Affairs.  The  new  health  record  shall  have  noted 
on  its  face  in  red  ink,  "  Naval  Militia  in  the  service  of  the  United  States." 

Section  5.— Detailed  Directions  Regarding  the  Heat.th  Kecords  of  Officers 
(Warrant  and  Commissionioj). 

2801.  An  officer's  health  record  must  accompany  him  throughout  his  service, 
its  care  and  disposition  being,  in  general,  the  same  as  that  prescribed  in  the 
case  of  enli.sted  men. 

2302.  If  an  officer  is  on  detached  duty  or  waiting  orders,  his  health  record 
will  be  forwarded  to  the  bureau  by  the  medical  officer  of  the  ship  or  station. 
All  officers  are  required  to  notify  the  medical  officer  of  their  detachment,  pro- 
motion, orders  before  board  of  medical  survey,  or  board  for  promotion,  retire- 
ment or  examination  for  special  duty  (aviator).      (Art.  I  70S  (2).) 

2303.  (a)  When  an  officer  is  ordered  before  a  board  for  promotion  or  retire- 
ment his  health  record  shall  be  forwarded  to  the  president  of  the  board  for  the 
findings  of  the  board  to  be  entered  therein,  to  be  subsequently  sent  to  the  appro- 
priate medical  officer  for  continuance  or  final  disposition.  When  examined  for 
promotion,  if  physically  qualified,  the  board  will  at  once  open  a  new  health 
record.  (See  par.  22G2')  The  new  health  record  shall  then  be  forwarded  with 
the  old  one  as  noted  above. 

(b)  In  the  case  of  an  officer  recommended  for  appointment  from  civil  life  or 
of  a  midshipman  entering  the  Naval  Academy,  the  board  will  proceed  with  the 
new  health  record  as  provided  for  in  the  case  of  promotion. 

2304.  Upon  termination  of  service  by  retirement  or  otherwise,  the  health 
rec-ord  is  closed  and,  with  abstract  appended,  should  be  forwarded  at  once  to 
the  Bureau  of  Medicine  and  Surgery. 

2305.  The  medical  history  is  kept  in  the  same  manner  as  that  for  enliste<l 
men   but  the  disposition  of  this  portion  of  the  health  record  differs  as  follows: 

On  the  first  of  each  year  all  pages  containing  medical  history  entries  made 
durin"'  the  preceding  12*  months  shall  be  detached  and  forwarded  at  once  to  the 
Bureau  of  Medicine  and  Surgery.  If  an  officer  is  on  the  sick  list  at  the  time, 
this  procedure  may  be  delayed  until  he  is  discharged  to  duty.  The  abstract  is 
retained  and  kept  up  to  date  In  all  cases. 

2306.  In  the  case  of  midshipmen  the  health  record  is  retained  intact  until 
termination  of  service  as  midshipman.     (I  5247  (2).) 

Section  6. — Health  Kecokds  of  Svphilittcs  (Enlisted  Men). 

2307.  To  make  the  records  of  syphilitic  patients  uniform  and  complete  and 
to  facilitate  accurate,  progressive,  scientific  treatment  by  enabling  each  medical 
ofiicer  to  know  exactly  when  and  how  diagnosis  was  established  and  how  far 
treatment  has  advanced: 

A  syphilitic  abstract  sheet  (yellow)  will  be  filled  out  and  Insertetl  into  tlie 
health  record  of  every  enlisted  man  requiring  it.  Every  new  ca'^e  shall  have 
such  a  Klieet  begun  by  the  medical  officer  making  the  original  diagnosis  and 
beginning  treatment.  For  every  syphilitic  already  under  treatment  the  sheet 
shall  be  made  out  by  the  medical  officer  now  having  charge  of  his  case.  The 
sypliilitic  abstract  is' Inserled  as  the  last  page  in  the  health  record.  It  follows 
the  same  course  as  the  abstract  of  health  record.  It  does  not  replace  any  part 
of  the  health  record  or  medical  history,  but  is  in  addition  to  them. 

Whenever  a  diagnosis  of  syphilis  Is  made  it  is  the  duty  of  the  medical  officer 
to  explain  carefully  and  fully  the  nature  of  the  infection  and  the  course  of 
conduct  and  treatment  necessary  to  a  cure,  and  to  convince  the  patient  that  he 


MANUAL   FOE   THE    MEDICAL  DEPARTMENT,   U.    S.    NAVY.        165 

hns  the  infection.  The  patient  is  then  requested  to  sign  the  statement  in  the 
"  abstract  "  and  if  he  declines  to  do  so  an  entry  to  that  effect  is  made  in  the 
first  line  of  "  Description." 

Under  the  caption  "  Description  "  should  be  entered  and  briefly  described  the 
lesions  existing  at  time  diagnouis  was  made,  or  soon  thereafter,  so  that,  taken 
with  the  data  under  "  Diagnosis,"  the  existence  of  the  disease  can  not  be 
controverted  in  after  years. 

Below  "  Description  "  should  be  entered,  as  they  are  made,  the  various  serum 
tests,  using  abbreviations,  if  necessary,  No.  for  Noguchi,  Wa.  for  Wassermann, 
followed  by  plus  or  minus  and  figures.  On  the  other  side  of  the  sheet  give  a 
summary  of  treatment  up  to  time  of  transfer  of  the  man  or  detachment  of  the 
medical  officer  having  charge  of  the  case.    Thus : 

Vermont:  1.3.1917—2.6.1918. 

.Salvarsan,  3  doses,  .6  grams  each.    Mercury,  12  injections,  .01 

grammes  bichloride. 
Inunctions  daily  for  one  month.     Special  treatment  iritis  (1.)  3.1917. 

Good  results.  J.  Doe. 

The  data  necessary  for  this  sheet  can,  during  the  course  of  treatment,  be 
recorded  in  rough,  as  each  medical  officer  prefers,  using  blank  books  or  card 
index  so  as  to  permit  rapid  entries  at  time  of  transfer. 

Section  7. — EseokS  and  Omissions. 

2308.  (a)  The  attention  of  all  medical  officers  is  called  to  the  great  number 
of  errors,  omissions  of  necessary  data,  and  the  improper  disposition  of  the 
health  records  of  officers  and  enlisted  men.  The  printed  instructions  explain 
very  fully  all  the  necessai*y  entries  and  proper  disposition  to  be  made  of  it, 
and  it  is'  only  necessary  for  the  medical  officer  to  read  carefully  and  follow 
these  instructions  to  prevent  errors  and  omissions  and  to  keep  the  record  from 
being  lost  or  going  astray. 

(ft)  Whenever  a  health  record  is  received,  tlie  medical  officer  sliould  examine 
it  carefully,  correct  all  errors,  supply  all  omissions  as  far  as  practicable,  and, 
when  necessary,  communicate  with  metlical  officers  in  whose  custody  it  formerly 
was  for  the  data  necessary  to  correct  and  complete  the  record  to  date. 

(c)  When  there  is  no  health  record  of  an  officer  or  man  on  file  at  his  station, 
the  medical  officer  should  endeavor  to  find  out  of  there  is  one  elsewhere,  and,  if 
not,  he  should  open  a  record  at  once. 

(d)  Medical  officers  should  keep  themselves  informed  of  the  changes  in  the 
personnel  of  their  stations  and  promptly  dispose  of  the  health  records,  other- 
wise the  records  of  those  transferred  will  accumulate  and  not  be  forwarded  to 
their  proper  destinations. 

(e)  Health  records  should  be  forwarded  promptly  through  official  channels 
to  their  proper  destination  and  not  transmitted  by  officers  or  enlisted  men. 

(/)  In  the  case  of  a  man  extending  his  enlistment,  his  health  record  shall 
not  be  closed  and  forwarded  until  his  service  covering  the  extension  has  been 
terminated. 

(jfjr)  When  corresponding  with  the  bureau  relative  to  personnel,  the  Christian 
and  surname  and  the  grade  or  rank  should  be  stated  in  full,  especially  when 
writing  with  reference  to  the  health  records. 

(ft)  If  it  becomes  necessary  to  forward  a  health  record  to  the  bureau  for  any 
reason  not  stated  therein,  it  should  be  accompanied  by  a  letter  of  explanation. 

(i)  The  bureau  directs  that  particular  attention  be  given  to  the  following  en- 
tries in  the  records: 

(1)  Rank  or  rating  frequently  omitted  or  not  correctly  given  on  cover. 

(2)  Data  required  not  given  in  full  on  first  and  second  pages  and  signature  of 
medical  officer  often  does  not  appear. 


1^6        MANUAL   iOR   THE   MEDICAL    DEPARTMENT,    U.    S.    NAVY, 
C» 

(3)  Promotiou  of  officer  or  termination  of  service  of  enlisted  man  often 
fiiuittefl  on  puge  for  that  purpose. 

(4)  Number  of  enlistment  not  marked. 

(5)  Name  of  patient  not  given  on  eacli  sheet  of  medical  history. 

(6)  Name  of  man  omitted  from  abstract. 

(7)  Medical  officers  often  initial  and  do  not  sign  abstracts. 

(8)  Abstracts  often  do  not  show  data  of  attachment  or  detachment 

(9)  In  cases  of  immediate  reenlistment  the  abstract  is  often  not  detached 
from  old  and  attached  to  new  record. 

(10)  Administration  of  typhoid  prophylactic  frequently  omitted  from 
abstract. 

(;■)  Each  quarter  a  careful  inventory  should  be  liiade  of  tlie  health  records 
on  file  to  determine  if  they  correspond  with  the  muster  roll.  (M.  ;ind  S.  No. 
124680.) 

(fc)   Entries  about  smallpox  vaccination  scars  omitted. 

Section   8. — Navy   Regui.ations   and  Navax  Instbuctxons   Relating   to   the 

.TOTTRNAI.  OF  the  MeDICAL  DEPARTMENT, 

2811.  Monthly  entries  at  shore  stations.    R  2901  (2). 

2312.  Commanding  officer  will  Inspect  whenever  he  considers  It  necessary. 
I  2619  (2). 

2313.  Inspection  of  medicines,  etc.,  at  hospitals  to  be  entered  in  journal. 
I  3225. 

2314.  Officer  of  day  to  keep  Journal.    I  3227  (2). 

2315.  Examination  of  water  to  be  recorded  in  journal,    I  2112. 

2316.  Every  hospital  ship  and  station  to  keep  journal.    I  3251;  I  3252. 

2317.  All  changes  in  the  status  of  personnel  of  the  Nurse  Corps  are  subjects 
for  entry  in  hospital  journal.     (M,  &  S.  No.  123093.) 

2318.  The  senior  medical  officer  of  a  ship,  station,  hospital,  or  other  plate 
of  duty  shall  keep,  or  cause  to  be  kejit.  by  a  medical  officer,  a  journal  which 
sliall  be  a  complete,  succinct  record  of  affairs  coming  within  the  province  of  the 
Medical  Department  other  than  the  medical  history  of  individuals  which  is 
recorded  in  the  health  recortls.  For  example,  official  inspections  of  the  ship  or 
station,  of  the  ship's  company,  the  movements  of  a  cruising  ship,  deaths,  in- 
quests, autopsies,  sanitary  and  other  reports  and  recommendations  by  the  medi- 
cal officer,  inspections  of  food  and  water,  the  vaccination  of  the  personnel,  atui 
the  administration  of  typhoid  prophylactic,  and  the  presence  of  an  epiileniic. 
The  forwarding  of  requisitions  and  the  receipt  of  stores,  the  loss  or  destruction 
of  medical  or  surgical  supplies,  and  changes  in  the  personnel  of  the  IMedica! 
Department  should  also  be  entered  in  the  journal. 

'    The  journal  should  be  retained  as  a  permanent  record  until  a  ship  goes  out  oi" 

commission  or  station   is  closed,   when  it  shall  be  forwarded  to  the  bureau. 

It  2124  (1)  c.) 

,,  2310.  The  medical  officer  of  a  ishore  station  shall  see  that  a  proper  record  of 

all  births  occurring  within  the  limits  of  the  station  is  entered  in  the  medical 

journal. 

SEOTlOljI  9i^N0MENCLATXIBE  OF  DISEA8ES  AND  InJUBIKS. 

2321.  The  following  list  of  diseases  and  injuries  shall  be  used  for  the  official 
cecording  of  disahlUties  and  in  all  returns  to  the  Bureau  of  .Medicine  and 
Surgery.     (Par.  2359.)       , 

2822.  The  olijecl  of  the  adoption  of  this  nomenclature  is: 

(a)  To  allow  more  latitude  In  diagnosis  by  providing  a  list  03E  titles,  of  dis- 
abilities to  which  adult  malc<  are  subject.  .         . 

(b)  To  furnish  :i  list  of  titles  with  which  the  me<lical  profession  of  the  irnUe<l 
States  is,  or  probably  will  be,  the  more  faniiilar. 

(c)  To  secure  inforni.ilion  as  to  Hie  cause  of  injuries. 


MANUAL   i'Oll   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVW        167 

2323  This  list  is  composed  of  titles  accepted  by  the  committee  on  clinical 
records  of  the  Bellevue  Hospital,  of  New  York  City,  with  some  changes  deemed 
desirable  for  naval  use.  The  list  is  arranged  alphabetically,  and  separately  for 
diseases  and  injuries.  The  class  and  international  numbers  are  given  for  refer- 
ence only,  not  for  use.  .         ^       ,,„*,.  . 

•>305  For  the  titles  of  all  injuries  (wounds,  etc.,  and  poisons)  a  key  lettei 
referring'  to  the  cause  under  which  the  injury  was  received  is  required  on  all 
forms  In  the  health  record  and  on  forms  not  specially  ruled  the  key  letter  is  to 
follow  the  title,  as  "Wound,  gunshot,  neck  (K),''  etc.  

2326  In  the  health  record  the  key  letter  is  to  follow  the  title  as  Wound, 
-uushot  (A)  "  indicating  that  it  was  inflicted  with  suicidal  Intent;  the  same 
title  with  (B)  would  show  that  it  was  homicidal,  while,  if  received  in  action, 
the  key  letter  (K)  would  be  used.  ;  - 

2329    The  following  points  are  to  be  observed  in  assigning  a  diagnosis . 

(a)  The  class  and  international  numbers  are  given  for  reference  only,  not 

(&)  Titles  in  italics,  which  are  symptoms,  are  not  to  be  usefl  except  when  the 
primary  disability  is  not  determined.  .    ,n  v,      ,        *^  ^r^ 

(c)  When  two  or  more  morbid  entities  exist,  preference  shall  be  given  to  (I) 
an  infective  disease;  (II)  the  graver  affection;  and  (III)  a  primary  disability 
over  a  complication.  ,,^    ,  „         •   ..     ^    i  ^ 

2331  (o)  Certain  title.=:  followed  by  the  word  "  unqualified  are  intended  to 
cover  such  cases  of  those  disabilities  for  which  no  other  title  is  provided  and 
where  occurring  the  word  "  unqualified  "  .shall  be  substituted  by  the  site  of  the 
disabilitv  or  the  principaJ  organ  ailected.  as  abscess  of  neck,  etc.,  or  for  instance 
epididymitis  or  orchitis,  when  due  to  a  gonococcus  infection  should  be  returned 
as  Gon.  inf.  of  epididymus  and  Gon.  inf.  of  testicle. 

(h)  All  gonococcal,  syphilitic,  and  chancroidal  infections  must  be  recorded 
under  these  titles,  and  titles  such  as  cystitis  acute,  epididymitis  acute,  gone- 
cystitis  acute,  orchitis  acute,  urethritis  acute,  etc.,  must  not  be  used  as  primary 
d'iasnoses  when  due  to  venereal  infection. 

2332.  The  proper  use  of  the  titles  "  Malingering,"  No  disease,  and  Diag- 
nosis undetermined,"  is  as  follows :  The  first  is  when  a  patient  claims  to  be  ill 
or'^unduly  exaggerates  a  disability  when  the  medical  officer  is  of  the  opinion 
that  there  is  none  or  only  slight  actual  disability ;  "  No  disease  "  is  to  be  used 
for  individuals  who  for  any  reason  have  to  be  carried  on  the  Medical  Depart- 
ment returns  as  for  rations  or  as  "  suspects  "  under  observation  for  infectious 
diseases  do  not  claim  to  be  sick  and  are  not  regarded  as  such  by  the  medical 
officer ;  and  "  Diagnosis  undetermined  "  is  to  be  used  when  there  is  an  evident 
disability  present,  the  nature  of  which  is,  at  the  time,  not  evident. 

2333.  No  other  titles  than  those  of  the  following  list  are  to  be  used  in  official 

2334  Inasmuch  as  a  correct  translation  of  naval  vital  statistics  of  injuries 
into  those  of  the  international  classification  requires  an  arrangement  accord- 
ing to  causes,  it  is  necessary  that  the  returns  show  the  cause  as  well  as  the 

nature  of  the  injury.  ......    v  •      o  ^=^11-.,...  > ) 

2335.  The  classification  of  causes  desiretl  by  the  bureau  is  as  follo\\  s . 

A.  Suicidal. 

B.  Homicidal.  .  ^  ,         ^d         4.- 

C.  Conflagration.  Includes  all  injuries  Incident  to  general  conflagi-ation. 
Burns  otherwise  received  are  not  classed  hereunder. 

D.  Accidental  drowning  or  submersion.  _  .  .  ,  ,.  ,  4  ,  ,  ,.i 
•  B  Traumatism  by  firearms,  accidental.  To  include  all  injuries  caused  by 
the  proiectile,  the  blast  from  great  guns,  or  from  the  piece  when  fired. 

F.  Traumatism  by  explosion.  To  include  powder,  gas,  compre.ssed  air,  or 
steam  explosions,  also  the  explosion  of  a  gun.  ,,     ,^^^., 

G.  Traumatism  by  fall. 

H.  Traumatism  by  machines. 
I.  Traumatism  by  other,  crushing..  ^_     _.    ,_ 


168        MANUAL  FOR  THE   MEDICAL  DEPARTME^^T,  U.   S.    NAVY. 

J,  Traumatism  due  to  athletic  sports. 

K.  Casualty  in  action  against  organized  enemy. 

L.  Traumatism  due  to  violence  other  than  noted  above. 

233(5.  The  above  key  letters  are  to  be  used  for  example,  as  follows:  Wound, 
gunshot,  of  brain  (A),  showing  that  it  was  inflicted  with  suicidal  Intent;  (B) 
tliat  it  was  homicidal,  while  if  received  in  action  the  entry  appears  ^s  (K). 
Accidental  drowning  or  .submersion  should  appear  with  the  suffix  (D),  while  if 
due  to  the  destruction  of  a  ship  by  fire  as  (C)  ;  if  incident  to  the  explosion  of  a 
magazine  as  (F),  unless  the  same  is  incident  to  action,  when  it  should  appear 
as  (K), 

2353.  A  diagnosis  shall  not  be  altered  on  the  returns  after  a  case  has  been 
closed  and  the  patient  transferred  unless  authorized  by  the  bureau. 

2354^.  Diagnosis  undetermined :  In  order  to  provide  for  the  admission  to  the 
sick  list  and  transfer  of  patients  where,  owing  to  insufficient  time  or  lack  of 
clinical  apparatus,  it  is  impracticable  for  the  medical  officer  to  make  other  than 
a  tentative  diagnosis,  the  use  of  the  designation  "  Diagnosis  undetermined  "  is 
made. 

The  object  is  to  prevent  the  recording  of  diagnoses  which  are  subsequently 
proved  to  be  erroneous  and  which  at  times  operate  detrimentally  to  the  future 
professional  prospects  of  the  patient. 

Under  no  circumstances  shall  a  case  of  diagnosis  undetermined  be  disposed  of 
as  to  duty,  died,  invalided  from  service,  hospital  for  the  insane,  hospital  for 
tuberculosis,  or  to  leave. 

Place  from  which  transferred :  The  case  shall  be  originally  entered  as  an  ad- 
mission and  when  disposed  of  should  appear  on  Form  F  (rough)  and  F  as 
"  Diagnosis  undetermined  "  and  the  other  usual  entries  made.  On  Form  K  It 
shall  be  listed  under  "  Disabilities "  with  diseases  or  injuries,  as  the  case 
may  be. 

Place  to  which  transferred :  When  a  case  with  "  Diagnosis  undetermined  "  is 
received  from  some  other  place,  it  shall  be  taken  up  as  a  readraission  (R.  A.), 
but  leave  the  diagnosis  space  open  until  established,  then  place  it  on  the 
records.  Cases  taken  up  with  "  Diagnosis  undetermined  "  and  transferred  to 
another  place  or  continued  to  nest  year  will,  however,  have  to  be  reported  to  the 
bureau  with  "  Diagnosis  undetermined  "  on  the  records. 

2355.  Specialty  key  letters:  The  specialization  of  certain  classes  of  naval 
work  and  the  peculiar  duties  surrounding  the  nature  of  the  work  makes  it 
desirable  to  inaugurate  a  system  of  special  designations  for  disea.sos  and  in- 
juries, and  for  this  purpo.se  the  following  liey  letters  shall  be  used  the  same  as 
key  letters  are  now  used  for  injuries. 

R=Aeronautic  duty.     For  diseases  or  Injuries  Incident  to  actual  flying. 
S=Submarine  duty.    For  diseases  or  injuries  Incident  to  actual  maneuver- 
ing of  or  accident  to  the  vessel. 
'U=Divers  duty.     For  diseases  or  injuries  Incident  to  actual  diving. 

When  used  in  connection  with  injury  key  letters,  first  give  key  letter  for 
Injury  and  follow  by  special  key  letter,  e.  g.,  drowning  Incident  to  flying 
(D-R)  ;  when  In  submarine,  (D-S)  ;  or  while  diving,  (D-U). 

The  specialty  key  letter  shall  not  be  used  for  all  persons  attached  to  special 
duty,  but  only  in  cases  of  actual  specialty  work — that  is,  a  person  attachtni  to 
aeronautic  or  submarine  duty  who  is  di.sabled  on  ordinary  occasions  should 
not  have  a  specialty  letter. 

No  otlier  than  ttiose  given  shall  be  used  as  prefixes  for  injuries  and  .«5hall  be 
followed,  as  requireil,  by  the  site  of  the  principal  traumatism  or  organ  Injureil. 

Under  poisons,  follow  tlie  word  poison  by  the  name  of  the  sub.stance,  and 
where  more  than  one  condition  of  poisoning  is  recognizefl  state  either  acute  or 
chronic. 

2357.  Medical  officers  on  recruiting  duty  or  at  places  from  wlilch  the  regu- 
lar I-'orms  F  and  K  are  n(»t  refiuircd.  sliall.  when  cases  of  Illness  or  Injury  are 
brought  to  their  attention,  prepare  and  forward  the  original  of  Form  F  (rough) 
and  retain  the  duplicate.     Cards  shall  be  sent  to  the  bureau  as  soon  as  the 


MANUAL  FOB  THE   MEDICAL  DEPARTMENT^   TJ.    S.    NAVY.        169 


case  is  discharged  to  duty  or  otherwise  disposed  of.  In  the  case  of  treatment 
of  persons  on  leave  from  their  regular  ship  or  station  the  medical  officer  at 
the  place  to  which  the  person  is  attached,  as  well  as  the  bureau,  shall  be 
informed. 

Section  10. — CJlassification. 

2358.  The  "  Navy  class  number  "  referred  to  in  the  following  pages  alludes 
to  the  classification  as  follows: 
I.  Diseases  of  blood. 
II.  Diseases  of  circulatory  system. 

III.  Diseases  of  digestive  system. 

IV.  Diseases  of  ductless  glands  and  spleen. 
V.  Diseases  of  ear. 

VI.  Diseases  of  eye  and  annexa. 

VII.  Diseases  of  genito-urinary  system  (nonvcnoreaI)« 
VIII.  Diseases  of  infective  type   (nonvenereal). 
IX.  Diseases  of  infective  type  (venereal). 
X.  Diseases  of  lymphatic  system. 
XI.  Diseases  of  mind. 
XII.  Diseases  of  motor  system. 

XIII.  Diseases  of  nervous  system, 

XIV.  Diseases  of  respiratory  system. 
XV.  Diseases  of  skin,  hair,  and  nails. 

XVI.  Hernise. 

XVII.  Miscellaneous  diseases  and  conditions. 
XVIII.  Parasites  (fungi  and  certain  animal  parasites), 
XIX.  Tumors. 
XX.  Injuries. 
XXI.  Poisons. 
The   "  international   number "   refers   to   the   classification   of  disease?^   and 
Injuries  prepared  by  the  International  Commission  (Paris,  July  1  to  3,  1909). 
These  numbers  are  given  for  reference  only,  not  for  use. 


Class  I. — Diseases  of  blood. 


Anemia,  pernicious. 
Anemia,  simple. 
Anemia,  splenic. 
Hemophilia. 


Leukemia. 

Polycythemia,  chronic. 

Purpura. 

Purpura,  hemorrhagic 


Class  II. — Diseases  of  circulatory  system. 


Aneurism. 

Aneurism,  cirsoid. 

Aneurism,  of  heart. 

Aneurism,  varicose. 

Aneurismal  varix. 

Angina  pectoris. 

Aortitis. 

Arterial  sclerosis,  general. 

Atrophy  of  heart. 

Bradycardia. 

Dilatation,  acute  cardiac. 

Dilatation,  chronic  cardiac. 

Embolism. 

Endocarditis,  acute. 

Endocarditis,  chronic. 

Fatty  heart. 


Heart  block. 

Hypertrophy  of  heart. 

Mediastino-pericardltls, 

Myocarditis,  acute. 

Myocarditis,  chronic. 

Palpitation,  cardiac. 

Pericarditis. 

Pericardium,  adherent. 

Phlebitis. 

Pneumopericardium. 

Pyopneuniopericardium. 

Rupture  of  heart,  spontaneous. 

Tachycardia. 

Thrombosis. 

Valvular  disease,  chronic  cardiac. 

Varix. 


170        MANUAL   VOU   THE    MEDICAL   DKPABTMENT,   U.    S.    NAVY, 


Class  III. — Diseases  of  digestive  syetem. 


Abscess  about  rectuiu. 

Abscess  of  liver. 

Abscess  of  omentum. 

Abscess  of  pharynx. 

Abscess  of  salivary  gland. 

Abscess  of  tongue. 

Abscess,  subphrenic. 

Achyila  gastrica. 

Adhesions  about  gall  bladder. 

Adhesions  about  stomach. 

Adhesions  of  peritoneum. 

Angina  ludovici. 

Appendicitis,  acute. 

Appendicitis,  chronic. 

Artificial  anus. 

Atony  of  stomach. 

Atrophy  of  liver,  acute  yellow. 

Atrophy  of  pancreas. 

Atrophy  of  stomach. 

.\trophy  of  tongue. 

Autointoxication,  intestinal. 

Calculus  of  pancreas. 

Cardiospasm. 

Caries  of  tooth. 

Cholangitis,  acute. 

Cholangitis,  chronic. 

Cholecystitis,  acute. 

Cholecystitis,  chronic. 

Cholelithiasis. 

Chyle  cyst  of  mesentery. 

Chylous  ascites,  nonfllarial. 

Cirrhosis  of  liver,  atrophic. 

Cirrhosis  of  liver,  hypertrophic. 

Colitis,  acute. 

Colitis,  chronic. 

Concretions  In  salivary  gland. 

Concretion  in  tonsil. 

Constipation. 

Deformity  of  liver,  acquired. 

Deformity  of  palate,  acquired. 

Deformity  of  stomach,  acquired. 

Dilatation  of  esophagus. 

Dilatation  of  stomach,  acute. 

Dilatation  of  stomach,  chronic. 

Displacement  of  liver. 

Diverticulitis. 

Diverticulum  of  esophagus. 

Divertl(;nhim  of  intestines,    acquired. 

Dnodenltis. 

Elongation  of  uvula. 

Enteritis,  acute. 

Enteritis,  chronic. 

Enterocolitis. 

Enterolith. 

Esophagitls. 

Fatty  liver. 

Fermentation,  Ka.strlc. 


Fermentation,  Intestinal. 

Fissure  of  anus. 

Fistula,  biliary. 

Fistula,  fecal. 

Fistula  in  ano. 

Fistula  of  (salivary  gland  or  duct). 

Foreign  body  in  esophagus. 

Foreign  body  in  intestines. 

Foreign  body  in  pharnyx. 

Foreign  body  in  rectum. 

Foreign  body  in  stomach.      .  t 

Functional  derangement  of  Uver. 

Gaseous  tumor  of  parotid. 

Gastritis,  acute  catarrhal. 

Gastritis,  chronic  catarrhal. 

Gastritis,  acute  phlegmonous. 

Gastroduodenl  tls. 

Gastroenteritis. 

Gastroptosis. 

Gingivitis. 

Glossitis,  acute. 

Glo.ssitis,  chronic. 

Hematemesis. 

Hemorrhage,  intestinal. 

Hemorrhoids. 

Hyperchylia,  gastric. 

Hypertrophy  of  tonsil. 

Hyperchlorhydria. 

Impacted  feces. 

Inflammation  of  salivary  gland. 

Nervous  dyspepsia. 

Neurosis,  intestinal. 

Neurosis  of  pharynx. 

Obstruction,  acute  intestinal. 

Obstruction,  chronic  intestinal. 

Obstruction  of  pancreatic  duct.    . 

Obstruction  of  portal  vein. 

Pancreatitis,  acute. 

Pancreatitis,  chronic. 

Peritonitis,  acute,  general. 

Peritonitis,  acute,  local. 

Peritonitis,  chronic,  general. 

Peritonitis,  chronic,  local. 

Perihepatitis. 

Perversion  of  appetite. 

Pharyngitis,  acute. 

Pharyngitis,  chronic. 

Pneumophagia. 

Proctalgia. 

Proctitis. 

Prolap.sc   of   rectum. 

Pylephlebitis. 

Pyloric  incontinence. 

Pylorospasm. 

Pyorrhoea  alveolarls. 

Itl'gurgitation  of  stomach. 

Rumination  ,,     ,,    ,, 


K 

K 

.lA 

•A 


MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY.        171 


Class  111.— Dimaaes  oi  digestive  system — Conlinued. 


Rupture  of  esophagus,  spontaneous. 

Spasm  of  esophagus. 

Spasm  of  rectum. 

Splanchnoptosis. 

Sprue. 

Stenosis  of  gall  duct. 

Stenosis  of  pylorus. 

Stomatitis. 

Stomatitis,  gangrenous. 

Stricture  of  esophagus. 

Stricture  of  intestine. 

Stricture  of  pharynx. 


Stricture  of  rectum. 
Tonsillitis,  acute  follicular. 
Tonsillitis,  chronic. 
Torsion  of  omentum. 
Ulcer  of  duodenum. 
Ulcer  of  intestines. 
Ulcer  of  mouth. 
Ulcer  of  rectum. 
Ulcer  of  stomach. 
Ulceromembranous  angina. 
Vomiting,  recurrent. 
Xerostomia. 


Class  IV. — Diseasf^s  of  iluctless  glands  and  spleen. 


Abscess  of  spleen. 

Acromegaly. 

Addison's  disease. 

Cretinism. 

Exophthalmic  goitre. 

Goitre. 

Hemorrhage  into  parathyroid  gland. 

Hemorrhage  into  suprarenal  gland. 

Infarct  of  spleen. 


Myxedema. 

Perisplenitis. 

Persistent  thymus  gland. 

Rupture  of  spleen,  spontaneoiis. 

Splenitis,  acute. 

Splenitis,  chronic  interstitial. 

Splenoptosis.  i.jjji,  iuodt;  ; 

Thyroiditis,  acute,      -    -  -  .  r 

Thyroiditis,  chronic. 


Class  iV,— Diseases  of  ear. 


Ankylosis  of  ossicles. 
Caries  of  ossicle. 
Cerumen,  accumulation  of.    ^    ,   ; 
Deafness.  ,1;   ."j,' 

Deformity  of  external  ear,  acquired. 
Eustachian  salpingitis,  acute. 
Eustachian  salpingitis,  chronic. 
Foreign  body  in  auditory  canal. 
Hematoma   of  external   ear.   nontrau- 
matic. 
Hemorrhage  into  labyrinth. 


Mastoiditis,  acute. 
Mastoiditis,  chronic. 
Myringitis,  acute. 
Myringitis,  chronic. 
Ossification  of  auricle. 
Otitis  externa. 
Otitis  interna,  acute. 
Otitis  interna,  chronic. 
Otitis  media,  acute. 
Otitis  media,  chronic. 
Perichondritis  of  auricle. 


Class  VI,— i^,i|S<!<)«f.s  of  eye  and  adnexa. 


Abscess  of  eye  and  adnexa. 

Absence  of  Ifens. 

Amaurosis. 

^Vmblyopla. 

Ankyloblepharon. 

Astigmatism. 

Atrophy  of  optic  nerve. 

Blepharitis. 

Cataract. 

Chalazion. 

Choroiditis. 

Color  blindness. 

Conjunctivitis,  acute. 

Conjunctivitis,  chronic. 

Conjunctivitis,  phlyctenular. 

Cramp  of  ciliary  muscle. 


Cyclitis. 
Dacryoadenitis. 
Dacryocystitis. 
Detachment  of  choroid. 
Detachment  of  retina. 
Ectropion. 
Entropion. 

Epiphora.  I 

Fistula  of  lachrymal  sac  * 

Fistula  of  nasal  duct 
Glaucoma,  acute. 
Glaucoma,  chronic. 
Hemianopsia. 

Hemorrhage  into  retina.  _-     ; 

Hemorrhage   \inder   conjiiuctivR,wi>oip^ 
traumatic. 


172        MANUAL  FOR   THE   MEDICAL  DEPARTMENT,  IT.   8.   NAVY. 


Class  VI. — Diseases  of  eye  and  adnexa — Continued. 


Hordeolum. 

Hyperesthesia  of  retina. 

Hyperemia  of  conjunctiva. 

Hypernietropia. 

Hypopyon. 

Insufticiency  of  ocular  muscle. 

Iridochoroiditis. 

Iridocyclitis. 

Iritis. 

Keratitis. 

Keratitis,  phlyctenular. 

Keratoiritis. 

Leulioma. 

Myopia. 

Neuritis,  optic. 

Neuroretinitis. 

Night  blindness. 

Nystagmus. 


Opacity  of  vitreous  humor. 

Ophthalmoplegia. 

Panophthalmitis. 

Paralysis  of  ocular  muscle. 

Presbyopia. 

Pterygium. 

Retinitis. 

Scleritis, 

Snow  blindness. 

Staphyloma  of  cornea. 

Stenosis  of  nasal  duct. 

Stenosis  of  punctum  lacrlmale.  ''• 

Symblepharon. 

Synechia. 

Trachoma. 

Trichiasis.  Ti^^d^. 

Ulcer  of  eye  and  adnexa.  '^ 

Xerosis.  -^* 


Class  VII. — Diseases  of  ffenUo-urinary  system  (nonvcnercal). 


Abscess  about  urethra. 
Abscess  of  bladder  wall. 
Abscess  of  Cowper's  glands. 
Abscess  of  kidney. 
Abscess  of  kidney,  perinephvitic 
Abscess  of  prostate  gland. 
Abscess  of  scrotum. 
Adhesions,  preputial. 
Albuminuria.. 
Atony  of  bladder. 
Atrophy  of  prostate. 
Atrophy  of  testicle. 
Bacteriuria. 
Balanoposthitls. 
Calculus  in  bladder. 
Calculus  in  prostate. 
Calculus  in  ureter,  impacted. 
Calculus  in  urethra,  impacted. 
Chylocele,  nonfilarial. 
Chyluria,  nonfilarial. 
Concretion  In  seminal  vesical. 
Concretions,  preputial. 
Congestion  of  kidney. 
Cystitis,  acute. 
Cystitis,  chronic. 
Cyst  of  kidney. 

Deformity  of  bladder,  acquired. 
Deformity  of  penis,  acquired. 
Deformity  of  urethra,  acquired. 
Enlargement  of  prostate. 
Epidi<lymitis,  acute. 
Epididymitis,  chronic. 
Extravasation  of  urine. 
Fistula,  Intrstino-uretern!. 
Fistula,  intestlno-veslcal. 


3 
O 

H 
TiB^al 


Fistula  of  bladder. 

Fistula  of  kidney. 

Fistula  of  ureter. 

Fistula  of  urethra. 

Fistula,  recto-urethral. 

Fistula,  uretero-vesical. 

Fistula,  urethro-vesical. 

Foreign  body  in  bladder. 

Foreign  body  in  ureter. 

Foreign  body  in  urethra. 

Gonecystitis,  acute  (non venereal), 

Gonecystitis,  chronic  (nonvencreal).  ^ 

Hematocele  of  spermatic  cord. 

Hematoma  of  spermatic  cord,  nontrau 

matic. 
Hematuria,  renal. 
Hemoglobinuria. 
Plydrocele  of  spermatic  cord. 
Hydrocele  of  tunica  vaginalis. 
Hydronephrosis. 
Impotence. 

Incontinence  of  urine. 
Infarct  of  kidney. 
Innammation  of  spermatic  cord. 
Masturbation. 
Nei)liralgia. 
Nephritis,  acute. 
Nei)hritis.  chronic  interstitial. 
Nephritis,  chronic  parenchymatous. 
Nephritis,  disseminated,  suppurative. 
Nephrolithiasis. 
Neijlintjitosis. 
Neurosis  of  bladder. 
Orchitis,  acute. 
Orchitis,  chronic 


r{ 


MANUAL   FOR  THE    MEDICAL   DEPARTMENT,  U.   S.    NAVY.        173 


Class  VII. — Diseases  of  genito-urinary  system   (nonvenereal) — Continued. 


Paraphimosis. 

Phimosis. 

Prostatitis,  acute. 

Prostatitis,  chronic. 

Pyelitis. 

Pyelonephritis. 

Redundant  prepuce. 

Redundant  scrotum. 

Sclerosis  of  corpus  cavernosum. 

Seminal  emissions. 

Spermatocele. 

Spermatorrhea. 


Sterility. 

Stricture  of  ureter. 
Stricture  of  urethra. 
Suppression  of  urine. 
Torsion   of   spermatic   cord,    nontrau- 
matic. 
Ulcer  of  bladder. 
Ureteral  colic. 
Ureteritis. 
Urethritis,  acute. 
Urethritis,  chronic 
Varicocele. 


Glass  VIIL — Diseases  of  infective  type  (nonvenereal). 


Abscess,  unqualified. 

A,erogenes  capsulatus  infection. 

Anthrax. 

Carbuncle. 

Carrier,  common  bacillus. 

Carrier,  diphtheria  bacillus. 

Carrier,  typhoid  bacillus. 

Cellulitis. 

Cerebrospinal  fever. 

Chicken  pox. 

Cholera,   asiatic. 

Dengue. 

Diphtheria. 

Dysentery,  bacillary. 

Dysentery,  unclassified. 

Erysipelas. 

Fever  of  unknown  cause. 

Foot-and-mouth  disease. 

Furunculosis. 

Gangosa. 

Gangrene,  Infective. 

German  measles. 

Glanders. 

Hemoglobinuric  fever. 

Histoplasmosis. 

Influenza. 

Jaundice,  acute  infective. 

Kala-azar. 

Leprosy. 

Malaria. 

Measles. 

Miliary  fever. 

Mumps. 

Oriental  sore. 

Pappataci   fever. 

Paratyphoid  fever. 

Pellagra. 

Class  IX. — Diseases  of  infective  type  {venereal) 

Chancroid. 

Chancroid  of  lymph-node. 
Gonococcus  infection  of  conjunctiva. 
Gonococcus  infection  of  Joints. 


Plague. 

Poliomyelitis,  acute  anterior. 

Poliomyelitis,  chronic  anterior. 

Poliomyelitis,  acute  bulbar. 

Rabies. 

Relapsing  fever. 

Rheumatic  fever,  acute. 

Rheumatic  fever,  subacute. 

Rocky  Mountain  spotted  fever. 

Scarlet  fever. 

Septicemia. 

Smallpox. 

Tetanus. 

Tuberculosis,  abdominal. 

Tuberculosis,  acute  broncho-pneumonic. 

Tuberculosis,  acute,  general. 

Tuberculosis,  acute  pnuemonic. 

Tuberculosis,  acute  pulmonary  miliary. 

Tuberculosis,  chronic  pulmonary. 

Tuberculosis  of  bronchus. 

Tuberculosis  of  joint. 

Tuberculosis  of  larynx. 

Tuberculosis  of  pleura. 

Tuberculosis  of  spinal  column. 

Tuberculosis  of  trachea. 

Tuberculosis,  unqualified. 

Tuberculous  meningitis. 

Typhoid  fever. 

Typhus  fever. 

Undulant  fever. 

Vaccinia. 

Veldt  sore. 

Verruca  peruana. 

Whooping  cough. 

Yaws. 

Yellow  fever. 


Gonococcus  infection  of  lymph-node. 
Gonococcus  infection  of  urethra. 
Gonococcus  infection,  unqualified. 
Syphilis. 


1'74        MANUAL   FOR   THE    MKmOAL   DEPARTMENT,   U.    B,    NAVY. 


Olars  X.— Diseases  of  lymphatic  system. 


Abscess  of  axilla. 
Abscess  of  lymph-node. 
Elephantiasis,  nonfilarlal. 
Fistula  of  thoracic  duct. 
Hodgkln's  disease. 


Lymphadenitis,  acute. 
Lymphadenitis,  chronic. 
Lymphangiectasls. 
Lymphangitis. 
Status  lymphatious. 


Ci.Ass  XI. — Diseases  of  mind. 


Constitutional  inferiority. 
Constitutional  psychopathic  state. 
Dementia,  cause  unknown. 
Dementia,  paralytica. 
Dementia,  praecox. 
Imbecility. 

Melancholia,  involutional. 
Paranoia. 
Paranoid  state. 
Psychastheuia. 

Psychosis,   due  to  organic   brain   dis- 
ease. 


Psychosis,  epileptic. 

Psychosis    (exhaustive,   Infective,   and 

toxic). 
Psychosis,  hysterical. 
Psychosis,  intoxication. 
Psychosis,  manic  depressive. 
Psychosis,  polyneuritic.  >,j/. 

Psychosis,  senile. 
Psychosis,  traumatic. 


Class  XU.—Diseases  of  motor  siistem. 


Amyotonia  congenita. 

Ankylosis  of  joint. 

Arthritis,  acute. 

Arthritis,  chronic. 

Arthritis,  deformans. 

Atrophy  of  (bone  or  cartilage). 

Atrophy  of  muscle. 

Bursitis,  acute. 

Bursitis,  chronic. 

Calcification  of  cartilage. 

Chondritis. 

Chondromalacia. 

Contracture  of  joint. 

Contracture  of  (muscle,  fascia,  tendon, 

or  sheath). 
Coxa  valga. 
Coxa  vara. 
Cramp  of  muscle. 
Curvature  of  spine. 
Ganglion. 
Genu  recurvatum. 
Genu  valgum. 
Genu  varum. 
Hallux  valgus. 
Hallux  varus. 
Hammer  toe. 

Hemorrhage  Into  joint,  nontraumatic. 
Hernia  of  (muscle,  fascia,  tendon,  or 

sheath). 


Hypertrophy  of  bone. 
Leontiasis  ossea. 
Loose  body  In  joint. 
Loss  of  substance  of    (bone  or  carti- 
lage). 
Mallet  finger. 
Meta  tarsalgia. 
Myositis,  acute. 
Myositis,  chronic. 
Myositis,  progressive  ossifying. 
Myositis,  traumatic  ossifying. 
Myotonia,  congenital. 
Necrosis. 

Ossification  of  cartilage,  unqualilied. 
Osteitis  deformans. 
Osteomalacia. 

Osteomyelitis,  acute. 

Ostoomyelitis,  chronic. 

Paralysis,  muscle,  Ischemic 

Periostitis,  acute. 

Periostitis,  chronic. 

Pes  cavus. 

Pes  planus. 

Talipes. 

Tenosynovitis. 

Trigger  finger. 

Union  of  fracture,  faulty. 


joitu   <nu'j'jt»'jviiuc) 


MAiTUAL   FOR    THE   MEDICAL  DEPARTMENT,   U.    S.    NAVT.        175 


Class  XIII. — Diseases  of  nervous  system. 


Abscess  of  brain. 

Anemia  of  brain. 

Angiospastic  edema. 

Aphasia. 

Apoplexy. 

Arterial  sclerosis,  cerebral. 

Ataxia,  hereditary. 

Athetosis. 

Caisson  disease. 

Catalepsy. 

Chorea. 

Chorea,  chronic  progressive. 

Cyst  of  brain. 

Dystrophy,  progressive  museulnr. 

Encephalitis,  acute.        , 

Epilepsy. 

Epilepsy,  Jacksonian. 

Hematomyelia. 

Hematorrhachis. 

Hemiplegia,  old. 

Hemorrhage,  epidural. 

Hemorrhage  into  cerebellum. 

Hemorrhage  into  cerebrum. 

Hemorrhage  into  medulla. 

Hemorrhage  into  pons. 

Hemorrhage,  subdural. 

Hernia  of  brain. 

Hiccough. 

Hydrocephalus,  acquired. 

Hypochondriasis. 

Hysteria. 

Locomotor  ataxia. 

M^ni&re's  disease. 

Meningitis,  cerebral. 


Meningitis,  cerebrospinal. 

Meningitis,  spinal. 

Myasthenia  gravis. 

Myelitis,  disseminated. 

Myelitis,  transverse. 

Neuralgia. 

Neurasthenia. 

Neuritis. 

Neuritis,  multiple. 

Neurosis,  occupational. 

Neurosis,  traumatic. 

Pachymeningitis,  cerebral. 

Pachymeningitis,  spinal. 

Paralysis,  acute  ascending. 

Paralysis,  agitans. 

Paralysis,  Brown-Sequard'.s. 

Paralysis  of  nerve. 

Paramyoclonus  multiplex. 

Paraplegia,  ataxic. 

Sclerosis,  amyotrophic  later 

Sclerosis,  disseminated. 

Sclerosis,  lateral. 

Somnambulism. 

Spasm  habit.  , 

Spasm  nodding.  '^'' 

Spasm  saltatory. 

Stammering. 

Stuttering. 

.Syringomyelia. 

Tic,  convulsive. 

Tic,  coordinated. 

Tic,  psychical. 

Zoster. 


•al. 


Class  XIV. — Diseases  of  respiratory  system. 


Abscess  of  larynx. 

Abscess  of  lung. 

Abscess  of  nasal  septum. 

Adenoids. 

.\dhesions  of  epiglottis. 

Ankylosis  of  arytenoid  cartilage. 

Anosmia. 

Asthma. 

Bronchiectasis. 

Bronchitis,  acute. 

Bronchitis,  chronic. 

Bronchitis,  fibrinous. 

Chylothorax. 

Congestion  of  lung,  acute. 

Deformity  of  nose,  acquired. 

Deviation  of  nasal  septum. 

Edema  of  glottis. 

Edema  of  lung. 

Emphysema,  pulmonary. 


Epiglottiditis. 

Epistaxis. 

Fistula  of  larynx. 

Fistula  of  trachea. 

Fistula,  thoraco-intestinal. 

Foreign  body  in  bronchus. 

Foreign  body  in  frontal  sinus. 

Foreign  body  In  larynx. 

Foreign  body  in  maxillary  sinus. 

Foreign  body  in  nasal  passage. 

Foreign  body  in  trachea. 

Gangrene  of  lung. 

Hay  fever. 

Hemoptysis. 

Hemothorax. 

Hernia  of  lung. 

Infarct  of  lung. 

Laryngitis,  acute. 

Laryngitis,  chronic. 


176        MANUAL   FOB   THE   MEDICAL  DEPABTMENT,   U.    S.    NAVY. 


Class  XIV. — Diseases  of  respiratory  system — Continued. 


Neurosis  of  larynx. 
Ossification  of  larynx. 
Ossification  of  tracheal  rings. 
Ozena. 

Paralysis  of  vocal  cords. 
Perforated  nasal  septum. 
Perichondritis  of  larynx. 
Pleurisy,  acute  fibrinous. 
Pleurisy,  chronic  fibrinous. 
I'leurisy,  serofibrinous. 
Pleurisy,  suppurative. 
Pleuritic  adhesions. 
Pneumatocele  capitis. 
Pneumonia,  broncho-. 
Pneumonia,  interstitial. 
Pneumonia,  lobar. 
Pneuraonoconiosis. 
Pneumothorax. 
Polypus,  nasal. 


Pyopneumothorax. 
Rhinitis,  acute. 
Rhinitis,  chronic. 
Rhinitis,  hypertrophic 
Rhinolith. 

Sinusitis,  ethmoidaL 
Sinusitis,  frontal. 
Sinusitis,  maxillary. 
Sinusitis,  sphenoidal. 
Spur  on  nasal  septum. 
Stenosis  of  bronchus. 
Stenosis  of  larynx. 
Stenosis  of  trachea. 
Tracheitis. 
Tracheocele. 
Ulcer  of  bronchus. 
Ulcer  of  epiglottis. 
Ulcer  of  nasal  passage. 
Ulcer  of  trachea. 


Class  XV. — Diseases  of  skin,  hair,  and  naiitm 


Acne. 
Alopecia. 
Alopecia  areata. 
Angiokeratoma. 
Anhidrosis. 
Atrophy  of  skin. 
Bromidrosis. 
Callositas. 
Chilblain. 
Chloasma. 
Chromidrosls. 
Cicatrix  of  skin. 
Clavus. 
Comedo. 
Cornu. 

Dermatitis  gangrenosa. 
Dermatitis  venenata. 
Dermatitis,  unqualified. 
Dysidrosls. 
Ecthyma. 
Eczema. 

Erythema   multiforme. 
Erythema  nodosum. 
Erythema  scarlatlnlforme. 
Erythema  simplex. 
Fissure  of  skin. 
Folliculitis  decalvans. 
Ilorpes. 
Ilyporldrosls. 
Iflithyosis. 
Impetigo  contagiosa. 
Impetigo  horpctiformls. 
Iitil>etlL'o  siniplex. 
Ingrowing  nalU 
Intertrigo. 


Keratodermia. 

Keratosis. 

Lentigo. 

Leukodermia. 

Leukokeratosls. 

Lichen,  planus. 

Lichen,  ruber. 

Lupus,  erythematous. 

Rlelanodermia. 

Miliaria. 

Milium. 

Molluscum  contagiosum. 

Mycosis  fungoides. 

Nevus. 

Onychauxis. 

Onychia. 

Onychoma. 

Pemphigus. 

Pityriasis  rosea. 

Pityriasis  simplex. 

Prurigo. 

I'ruritus. 

Psoriasis. 

Rhinoscleroma. 

Rosacea. 

Sclorodermla, 

.Scl)orrhoa. 

Sudamina. 

r\cer  of  skin. 

Urticaria. 

Urticaria  pigmentosa. 

Wart. 

Xantlinnia. 

Xerodermia  pigmentosa. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.    S.    NAVY. 


Class  XVI. — HernioB. 


Hernia,  epigastric 
Hernia,  femoral. 
Hernia,  inguinal. 
Hernia,  internal. 
Hernia,  ischiatic. 


Hernia,  ischiorectaL 
Hernia,  lumbar. 
Hernia,  obturator. 
Hernia,  umbilical. 
Hernia,  ventral. 


Class  XVII. — Miscellaneous  diseases  and  conditions. 


Acidosis,  nondiabetic 

Adiposis  dolorosa. 

Ainhum. 

Amputation,  stump. 

Amyloid  disease. 

Anti-inoculation,  unqualified. 

Beriberi. 

Cicatricial  contraction. 

Cystinuria. 

Dentition.  ^ 

Diabetes  insipidus. 

Diabetes  mellitus. 

Diagnosis  undetermined- 

Erythromelalgia. 

Gangrene. 

Gigantism. 

Glycosuria. 

Gout,  acute. 

Gout,  chronic. 

Headache. 

Hemochromatosis. 

Hypertrophy  of  mammary  gland. 

Insomnia. 

Llpemia. 


iMalformations,  congenital 

Malingering. 

Malnutrition. 

Migraine. 

Mikulicz's  disease. 

Milk  sickness. 

Nausea  marina. 

No  disease. 

Nostalgia. 

Obesity. 

Ochronosis. 

Osteoarthropathy,  hjT)ertrophic. 

Phantom  tumor. 

Raynaud's  disease. 

Rheumatism,  chronic  articular. 

Rheumatism,  muscular. 

Rickets. 

Scurvy. 

Senility. 

Shock. 

Sinus. 

Tetany. 

Vertigo. 


Class  XVIII. — Parasites  {fungi  and  certain  animal  parasites). 


Abscess,  entamebic,  liver. 

Abscess,  entamebic,  unqualified. 

Actinomycosis. 

Ascarlasis. 

Aspergillosis. 

Blastomycosis. 

Coccidiosis. 

Cysticercus  of  brain. 

Cysticercus  of  liver. 

Cysticercus  of  lung. 

Cysticercus,  unqualified. 

Dioctophyme  renale. 

Discomycosis. 

Dracontiasis. 

Dysentery,  balantidic. 

Dysentery,  entamebic. 

Echinococcus. 

Erysipeloid, 

Erythrasma. 

Favus. 

98601°— 17 12 


Filariasis. 

Flagellate  diarrhea. 

Larva  migrans. 

IVIetastrongylus  aprL 

Mucormycosis. 

Mycetoma. 

IMyiasis. 

Oxyuriasis. 

Paragonimiasis. 

Parameba  hominis. 

Pediculosis. 

Piedra. 

Pinta. 

Pityriasis  versicolor. 

Sarcopsiliasis. 

Scabies. 

Schistosomiasis,  intestinal. 

Schistosomiasis,  urinary. 

Sporotrichosis. 

Strongyloides,  intestinal. 


178        MANUAL  POK   TaV.   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 


Class  XVin. — Pomsites  {fvnfji  nml  certain  animal  parasite.^) — Continued. 


Strongjius,  Gibsoni. 

Teniasis. 

Thrush. 

Trichiniasis. 

Trichophytosis. 


Adenoma. 

Angioma. 

Carcinoma. 

Chondroma. 

Cystoma. 

Endothelioma. 

Epithelioma. 

Fibroma. 

Glioma. 

Hypernephroma. 

Lipoma. 

Lymphangioma. 


Trychostrongylus  insta bills. 

Trichuriasis. 

Trlchurls  trlchiura. 

Trypanosomiasis. 

Uncinariasis. 


Class  XIX. — Tumors. 


Lymphoma. 

Mixed  benign  tumor. 

Mixed  malignant  tumor. 

Myoma. 

Myxoma. 

Neuroma. 

Odontoma. 

Osteoma. 

Papilloma. 

Retention  cyst. 

Sarcoma. 

Teratoma. 


Class  XX. — Injuries. 


Abrasion. 

Air  embolism. 

Avulsion.  ■■^^■M^in  ^^- 

Blood  donor. 

Burn. 

(Castration. 

Compression. 

Contusion. 

Crush. 

Decapitation. 

Deprivation  of  water. 

Diagnosis  undetermined. 

Dislocation.  '■»''^'  w*.Di-v5- 

Drowning. 

Electric  shock. 

Emphysema. 

Epilation. 

Epiphyseal  separa<-ion. 

Exhaustion,  heat. 

Exhaustion,  overexertion. 

Exhaustion,  overexposui<'. 

Foreign  body. 

Fracture,  compound. 

Fracture,  simple. 

Fracture  of  penis. 

Frostbite. 

Heat  cramps. 

Hematocele,  tunica  vajfinHlTs. 

Hematoma. 


Hemorrhage  into  eyeball. 
Hemorrhage  into  joint. 
Hemorrhage  under  conjunctiva. 
Intracranial  Injury. 
Intraspinal  injury. 
Lightning  stroke. 
Multiple  injuries,  <^xtreme. 
Powdered  glass,  Injury  from  swnlb'W- 

ing. 
Rupture  (not  hernia). 
Skin  donor. 
Smoke  inhalation. 
Sprain. 
Starvation. 
Strain. 

Strangulation. 
Strangulation  of  penis. 
Submersion. 
Sunburn. 
Sunstroke. 
Synovitis. 

Thermic  fever.      .djncl  "{o 
Torsion,  spermatio'^Hl. 
Urethral  fever. 
Wound,  gimshot. 
Wound,  incised. 
Wound,  lacerated. 
Wound,  punctured. 


i^'fS. 


'»*nf  .'f.       Class  XX  I.  — y^oisorts. 


Botulism. 
Greatoxlsin, 

Diagnosis  undetermined. 
Insect  sting. 


Lathyrlsni. 
Poison,  anesthesia. 
I'oison   (stnt*'  <:ul •stance). 


MANUAL   FOE  THE  MEDICAL  DEPARTMENT,   U.    S.    NAVY.        179 
2359.  Section  11. — Diseases.' 


Navy 
class  No. 


Interna- 
tional No. 


Abscess  aboat  rectum 

Abscess  about  urethra 

Abscess,  entamebir,  liver . . ._. 
Abscess,  entamebic  unquali 

fied 

Abscess  of  axilla 

Abscess  of  bladder  wall 

Abscess  of  brain 

Abscess  of  Cowper's  glands. . . 
Abscess  of  eye  and  adnexa — 

Abscess  of  kidney 

Abscess  of   kidney,   perine- 

pliritic 

Abscess  of  larynx 

Abscess  of  liver 

Abscess  of  lung 

Abscess  of  lymph-node 

Abscess  of  nasal  septum 

Abscess  of  omentum 

Abscess  of  pharynx 

Abscess  of  prostate  gland 

Abscess  of  salivary  gland.  .... 

Abscess  of  scrotum 

Abscess  of  spleen ; 

Abscess  of  tongue 

Abscess,  subphrenic 

Abscess,  unqualified 

Absence  of  lens 

Vchylia  gastrica 

Acidosis,  nondiabetle , 

A.cnft 

Acromegaly 

Actinomycosis 

Addison's  disease 

Adenoids 

Adenoma 

Adhesions  about  gall  bladder . 

Adhesions  about  stomach 

Adhesions  of  epiglottis 

Adhesions  of  peritoneum 

Adhesions,  preputial 

AdijJOsis  dolorosa 

Aerogenes  capsulatus  Infec- 
tion  

AInhum 

A  Ibuminuria 

Alopecia 

Alopecia  areata 

A  mauTosis 

A  mblyopia 

Amputation  stump 

Amyloid  disease 

Amyotonia  congenita 

Anemia  of  brain 

A  neviia,  perrudous 

Antmta,  iimple 

Anemia,  splenic 

Aneurism 

Aneurism,  cirsoid 

Aneurism  of  heart 

Aneurism,  varicose 

Aneurisma!  varix 

Angina  ludovici 

Angina  ijeetoris 

Angiokeratoma 

Angioma 

Angiospastic  edema. 

Anidrosis 


m 

VII 
XVIII 

XA'III 
X 

vn 
xin 

VII 
VI 

vu 

VIT 

xrv 
III 

XTV 
X 

xrv 
m 
III 

VII 

III 

VII 

rv 
III 
in 

VIII 
VI 

III 

XVII 
XV 
IV 

xvin 

IV 

xrv 

XIX 

ni 
III 

XIV 

III 

VII 
XVII 

VIII 
XVII 

!      VII 

I      XV 

XV 

I       VI 

!     VI 

!    XVII 

j   xvn 

I      XII 

I    xni 

;  'I 
I 
I 
n 
II 
II 
II 
n 
in 
II 

XV 

XIX 

xin 

XV 


Navy 
class  No. 


Interna- 
tional Ko. 


HOB 

125 
115 

107 

84 
124 

60 
127 
75C 
122 

122 

87 

115 

98 

84 

86 

117 

100 

126 

99B 

127 

116 

993 

118 

144 

75C 

103 

55 

145C 

55 

25A 

52 

86 

46 

115 

117 

87 

117 

127 

55 

20 

149 

120 

145C 

145C 

75C 

75C 

149 

55 

149 

74 

54 

.■)4 

.".4 

si 

.si 

79C 

•SI 

.S3 

100 

SO 

145C 

46 

74 

145C 


Ankyloblepharon .'. . .;. 

Ankylosis  of  arytenoid  carti- 
lage  

jVnkylosis  of  jomt 

Ankylosis  of  ossicles 

Aiiosmia 

Anthrax 

Anti-inoculation,  unqualif?ed.l 

Aortitis | 

A  phasia 

A  poplczu '•'•  .'.'.".■■ 

Appendicitis,  acute. . . .'.  .'.■.■.".  - 

Appendicitis,  chronic. .' 

Arterial  sclerosis,  cerebral ' 

Arterial  sclerosis,  general \ 

Arthritis,  acute .'....' 

Arthritis,  chronic '. . . .  I 

Arthritis,  deformans ... 

Artificial  anus 

Ascariasis ...'■ 

Aspergillosis 

Asthma 

Astigmatism 

Ataxia,  hereditary | 

Athetosis 

Atony  o)  bladder..,, 

Atony  of  stomach ; 

Atrophy  of  (boneorcartilage). 

Atrophy  of  heart 

Atrophy  ofliver,  acute  yellow . 

Atrophy  of  muscle 

Atrophy  of  optic  nerrt 

Atrophy  of  pancreas 

Atrophy  of  prostate 

Atrophy  of  skin -  - . 

Atrophy  of  stomach ■.■.... 

Atrophy  of  testicle ..•.■.... 

Atrophy  of  tongue ..■."..:.. 

I  Autointoxication, intestinal. . 

I  Bacteriuria 

j  Balanoposthit  is 

I  Beriberi 

j  Blastomycosis •  -  -  • 

Blepharitis •  -  -  ■ 

Bradycardia 

I  Bromidrosis 

I  Bronchiectasis • . 

I  Bronchitis,  acute 

I  Bronchitis,  chronic 

Bronchitis,  fibrinous 

Bursitis,  acute 

Bursitis ,  chronic -  - 

Caisson  disease 

Calcification  of  cartilage 

Calculus  in  bladder 

Calculus  in  prostate 

Calculus  in  ureter,  impacted. 

Calculus  in  urethra,  impacted 

Calculus  of  pancreas 

Callositas .■.■.... 

Carbuncle ...V.'.. 

Carcinoma .",■.■... 

Cardiospasm .". . .  .'- 

Caries  of  ossicle '. --  -  - 

Caries  of  tooth ..■..'. 

Carrier,  comma  bacillus...'. . . 

Carrier,  diphtheria  bacillus . . 

Carrier,  typhoid  bacillus 


VI 

XIV 

xn 

V 
XIV 

vm 

xvn 

II 

XIII 

xm 
III 
HI 

XIII 

II 
xn 

XII 
XII 

III 

XVIII 

xvm 
xrv 

VI 

xm 
xin 

VII 

ni 
xn 
11 
in 
xn 

VI 

III 

VII 
XV 

m 
vn 
in 
III 

VII 
VII 

xvn 
xvin 

VI 

II 

XV 
XIV 
XIV 
XIV 
XIV 
XII 
XII 

xm 
xn 

VII 
VII 

\n\ 

Nil 

III 

XV 
VIII 
XIX 

m 

-     V 

m 

VIII 
VTII 

VITT 


'  lt«ms  in  Italics  are  symptoms  <)uly.    Sec  par.  2329  (6;. 


75C 

87 
147 
76 
86 
22 
1.89  .\ 
81 

74 
64 
108 
lOS 

81 

81 
147 
1!7 
ISA 
109 
107 
2.iB 

96 
750 

63 

74 
124 
103 
146 
79C 
HI 
149 
75C 
118 
126 
145C 
103 
127 
99B 
llOB 
124 
127 

27 
25B 
75C 

85 
145C 

9^ 

89 

90 

90 

149 

149 

74 

149 

123 

126 

12?. 

123 

118 

145C 

143 

3»-45 

103 

76 

99A 

12a 

9b. 

-f> 


180        MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 
Section  11. — Diseases — Continued. 


Catale]  )s  y 

Cataract 

Cellulitis 

Cerelirospinal  fe".  er 

Ceninien,  accuiBulittiou  of 

Chalazion 

Chancroid 

Chancroid  of  lym^-node 

(thicken  pox 

Chilblain 

Chloasma 

Cholanpitis,  acute 

Cholangitis;  chronic 

Cholecystitis,  acute 

Cholecystitis,  chronic 

Cholelithiasis 

Cholera,  asiatic 

Chondritis 

Chondroma 

Chondromalacia 

Chorea 

Chores,  chronic  progressive . . . 

Choroiditis 

Chromidrosis 

Chyle  cyst  of  mesentery 

Chyloce"lc,  nonfllarial 

Chylolhorax 

Chylous  ascites,  nonfilarial..... 

Chyluria,  nonfllarial 

Cicatricial  contraction 

Cicatrix  of  slan 

Cirrhosis  of  liver,  atrophic 

Cirrhosis  of  liver,  hypertrophic 

Clavus 

Coccidiosis 

f Colitis,  acute 

Colitis,  clironic 

Color  Mindness 

Comedo 

Concretion  in  salivary  pland . . 
Concretion  in  seminal  vescicle 

Concretion  in  tonsil 

Concretion,  preputial 

Congestion  of  kidney 

Congestion  of  lung,  acute 

Conjunct i\itis,  acute 

Conjunctivitis,  chronic 

CJonjuncth  itis,  phlyctenular. . 

Constipation 

Constitutional  inferiority 

Constitutional    psychopathic 

state 

Contracture  of  joint 

Contra<  ture  of  (muscle, fascia, 

tendon,  or  sheath) 

Comu 

Coxa  valga 

Coxa  vara 

Cramp  o( liliarv  muscle 

Cramp  of  muscle 

Cretinism 

Curvalure  of  spine 

Cyclltis 

Cysticercus  of  liraln 

Cysticercus  of  liver 

Cysticer(  us  of  lung 

Cystii'ercus,  imquulified 

Cystinuria 

Cystitis,  acute  (nonvcnereal) . . 
Cystiliii,  chronic  (nonvenrreal) 


Navv 
class  No. 


xm 

VI 
VIII 

^'III 

V 
VI 
IX 
IX 
VIII 
XV 
XV 

III 
III 
in 
ni 
HI 

VIII 

XII 
XIX 

XII 
XIII 
XIII 

VI 

XV 

III 

VII 
XIV 

HI 
vn 
xvn 

XV 

III 
III 

XV 
XVIII 

III 
III 

VI 
XV 

III 

VII 

III 

VII 
VII 
XIV 
VI 
VI 
VI 
HI 
XI 

XI 
XII 

XII 
XV 
XII 
XII 

VI 
XII 

IV 
XII 

VI 

XV  in 
XVIII 
XVIII 
XVIII 
XVII 
VII 
VII 


Interna- 
tional No. 


74 
75C 
144 

61a 

7r. 

75C 

38.\ 

38.\ 

19 

14oC 

145C 

115 

ll.'S 

115 

115 

114 

12 

149 

46 

147 

72 

74 

75C 

145C 

84 

S4 

84 

84 

121 

145C 

145C 

113 

113 

145C 

107 

105  B 

lO.'iB 

75C 

145C 

99  B 

127 

100 

127 

122 

94 

75A 

75  \ 

75  A. 

HOB 

68 

68 
147 

149 
145C 
147 
147 
75C 
149 
74 
3CC 
75C 
107 
107 
107 
107 
122 
124 
124 


Cyst  of  brain 

Cyst  of  kidney 

Cystoma 

Dacryoadenitis 

Uacryocystitis. .  - 

Deafnfss 

Deformity  of.  bladder,  ac- 
quired  

Deformity  of  external  ear,  ac- 
quired  

Deformity  of  liver,  acquired. . 

Deformity  ol  nose,  acquired. . 

Deformity  of  palate,  acquired. 

Deformity  of  penis,  acquired . . 

Deformity  of  stomach,  ac- 
quired  

Deformity  of  urethra,  ac- 
(luired 

Dementia,  cause  unknown 

Dementia,  paralytica 

Dementia,  praecox 

Dengue 

Dentition 

Dermatitis,  gangrenosa 

Dennat  it  is,  unqualified 

Dermatitis,  venenata 

Detachment  of  choroid 

Detachment  of  retina 

Deviation  of  nasal  septum 

Diabetes  insipidus 

Diabetes  mellitus 

Diagnosis,  undetermined 

Dilatation,  acute  cardiac 

Dilatation,  chronic  cardiac 

Dilatation  of  esophagus 

Dilatation  of  stomach,  acute. . 

Dilatation  of  stomach,  chronic. . 

Dioctophyme  renale , 

Diphtheria , 

Discomycosis , 

Di-splacement  of  liver , 

Diverticulitis ; 

Diverticulum  of  esophagus. . . 

Diverticulum  of  intestines,  ac- 
quired  

Dracontiiusis 

Duodenitis 

Dysentery,  bacillary 

Dysentery,  balantidic 

Dysentery,  entamebic 

Dysenterj,  uaclassilied 

Dysidrosis 

Dystrophy,  progressive  mus- 
cular. . .' 

Echinococcus 

Ecthyma 

Ectropion 

Eczema 

Edema  of  glottis 

Edema  oj  luiiy 

Elejihantiasis,  nonfllarial 

Elongation  of  uvula 

Embolism 

Emphysema,  pulmonary 

Enieplialitis,  acute 

Endocarditis,  acute 

Endocarditis,  rhronic 

Endothelioma 

EnlargetiiiMit  of  prostate 

Enteritis,  acute 


Kavy    I  Intema- 
class  No.  tional  No. 


XIII 

VII 
XIX 

VI 

VI 

V 

VII 
V 

III 

XIV 
HI 
VII 

HI 

VH 

XI 

XI 

XI 
VIII 
XVII 

XV 

XV 

XV 

VI 

VI 

XIV 
XVII 
XVII 
XVII 

II 
u 
III 

HI 

HI 
XVIII 
VIII 
XV  HI 

III 

HI 

HI 

HI 
XVIII 

III 
VHI 
XVIII 
XVIII 

^'HI 
XV 

XIII 
XVIII 
XV 
VI 
XV 
XIV 
XIV 

X 

HI 

H 

xrv 

XIH 

II 
11 

XIX 

vn 

HI 


74 
132 

46 
75C 
75C 

76 

134 

76 
115 

86 
146 
127 

103 

125 

68 

67 

68 

19 

189A 

142 

145C 

145C 

75C 

75C 

86 

55 

50 

189A 

79C 

79C 

101 

103 

103 

122 

9 

25B 

115 

HOB 

I'Jl 

HOB 
14.10 
105  B 
14A 
HB 

lie 

140 
145C 

03 

107 

145C 

75C 

M5C 

87 

•M 

H5t' 

100 

82 

97 

t'>Q 

7S 

79H 

39-43 

126 

105U 


MANUAL   FOR   THE   MEDICAL   DEPARTMENT,  U.   S.    NAVY.        181 
*■  Section  11. — Diseases — Continued. 


Navy 
class  No. 


Enteritis,  ohronic 

Enterocolitis 

Enterolith 

Entropion 

Epidiaymitis,  acute  (non ve- 
nereal)   

Epididymitis,  chronic  (non- 
venereal)  

Epiglottiditis 

Epilepsy 

Epilepsy,  Jacksonian 

Epiphora 

EpUtaxis 

Epithelioma 

Erysipelas 

Erysipeloid 

Erythema  multiforme 

Erythema  nodosum 

Erythema  scarlatiniforme .... 

Erythema  simplex 

Erythrasma 

Erythromelalgia 

Esophagitis 

Eustachian  salpingitis,  acute.. 

Eustachian  salpingitLs,  chronic 

Exophthalmic  goiter 

Extravasation  of  urine 

Fatty  heart 

Fatly  liver 

Faviis 

Fermentation,  gastric 

Fermentation,  intestinal 

Fever  of  unknown  cause 

Fibroma 

Filariasis 

Fissure  of  anus 

Fissm'e  of  sViii 

Fistula,  biliary 

Fistula,  fecal 

Fistula  in  ano 

Fistula,  intestino-ureteral 

Fistula,  intestino-vesical 

Fistula  of  bladder 

Fistula  of  kidney 

Fistula  of  larchrymal  sac 

Fistula  of  larynx 

Fistula  of  nasal  duct 

Fistula  of  salivary  (gland  or 
duct) 

Fistula  of  thoracic  duct 

Fistula  of  trachea 

Fistula  of  ureter 

Fistula  of  urethra 

Fistula,  recto-urethral 

Fistula,  thoraco-intestinal . . . 

Fistula,  uretero-vesical 

Fistula,  urethro-vesical 

Flagellate  diarrhea 

Folliculitis  dccalvans 

Foot-and-mouth  disease 

Foreign  body  in  auditory  canal 

Foreign  body  in  bladder 

Foreign  body  in  bronchus . . . 
Foreign  body  in  esophagus . . . 
Foreign  body  in  frontal  sinus. 
Foreign  body  in  intestines  — 

Foreign  body  in  larynx 

Foreign  body   in   maxillary 

sinus 

Foreign  body  in  nasal  passage. 


Ill 
III 
III 
VI 

VII 

VII 
XIV 
XIII 
XIII 

VI 
XIV 
XIX 
VIII 
XVIII 

XV 

XV 

XV 

XV 
XV  III 
XVII 

III 

V 
V 
IV 
VII 

II 
III 

XVIII 

III 
III 

VIII 
XIX 
XVIII 

ni 

XV 

III 
III 
III 

VII 
VII 
VII 
VII 

VI 
XIV 

VI 

III 

X 
XIV 
VII 
VII 
VII 
XIV 

vn 

VII 
XVIII 
XV 
VIII 
V 
VII 

xrv 
III 

XIV 

III 
xrv 

xrv 

XIV 


Interna- 
tional No. 


Navy      Intema- 
class  No.  tional  No. 


105B 
105B 
HOB 

75C 

127 

127. 

87 

69 

74 

75C 

85 

39-45 

18 

25B 

145C 

145C 

145C 

145" 

25B 

142 

101 

76 

76 

51 

125 

790 

113 

25B 

103 

105B 

189A 

46 

19 

llOA 

145' 

115 

llOA 

llOA 

125 

125 

125 

122 

75C 

87 

75C 

99B 

84 

98 

125 

125 

125 

93 

125 

125 

105B 

145t' 

19 

76 

124 

186 

101 

146 

HOB 

186 

146 
186 


Foreign  body  in  pharynx 

Foreign  body  in  rectum 

Foreign  body  in  stomach 

Foreign  body  in  trachea 

Foreign  body  in  ureter 

Foreign  body  in  urethra 

Functional    derangement    of 

Uver 

Furunc  ulosis 

Ganglion 

Gangosa 

Gangrene 

Gangrene,  infective 

Gangrene  of  lung 

Gaseous  tumor  of  parotid 

Gastritis,  acute  catarrhal 

Gastritis,  chronic  catarrhal .. 
Gastritis,  acute  phlegmonous. 

Gastroduodenitis 

Gastroenteritis 

Gastropt  osis 

Genu  recurvatum 

Genu  valgum 

Genu  varum 

German  measles 

Gigantism 

Gingivitis 

Glanders 

Glaucoma,  acute 

Glaucoma,  chronic , 

Glioma 

Glossitis,  acute 

Glossitis,  chronic 

Glycosuria 

Goiter 

Gonecystitis,  acute  (nonvene- 
real) 

Gonecystitis,  chronic  (nonve- 
nereal) 

Gonococcus  toleciion  of  con- 
junctiva   

Gonococcus  infection  of  joints. 

Gonococcus    infection    of 
lymph-node 

Gonococcus  infection  of  ure- 
thra  -• 

Gonococcus  infection,  unqual- 
ified  

Gout,  acute 

Gout,  chronic 

Hallux  valgus 

Hallux  varus 

Hammer  toe 

Hay  fever ■ 

Headache • 

Heart  block 

Hematemesis 

Hematocele  of  spermatic  cord 

Hematoma  of  external  ear, 
nontraumatic 

Hematoma  of  spermatic  cord, 
nontraumatic 

Hematomye'.ia 

Hematorrhachis 

Hemataria,  renal 

Hemianopsia 

Hemiplegia,  old 

Hemochromatosis 

Hemoglobinuria 

Hemoglobinuric  fever 


ni 
III 
III 

XIV 
VII 
VII 

III 

VIII 
XII 
VIII 
XVII 
VIII 
XIV 

III 
III 
III 
III 
III 
III 
III 

XII 

xn 

XII 
VIII 
XVII 

III 

VIII 

VI 

VI 
XIX 

m 
III 

XVII 
IV 

vn 

VII 

IX 
IX 

IX 

IX 

IX 
XVII 

xvn 

XII 
XII 
XII 
XIV 
XVII 

II 
III 

VII 


VII 
XIII 
XIII 

VII 

VI 
XIII 
XVII 

VII 

VIII 


186 

HOB 

103 
186 
122 
125 

115 
143 
149 

19 
142 
142 

95 

99B 

103 

1(B 

103 

105  B 

105B 

103 

147 

147 

147 

19 

55 
99A 

21 
75C 
750 

46 
99B 
99B 

50 


127 

38B 
38B 

38B 

38B 

38B 

48C 

48C 

149 

149 

149 

98 

189A 

85 

las 

127 

76 

127 
63 
63 

122 

75C 
60 
55 

122 
19 


IS '2        MA^■^rA^.   1*PR   THE    MEDICAL  DEPARrMEiST,   U.    S.    iJAVV. 
Section  11. — Diseases — Continued.  .« 


Navy 
class  No. 


Uemoi.tiilia 

Hemoptt/sif 

Hemorrhage,  epidural 

JJi  iiiorrhaje,  imutinal 

Hemorrhage  into  ccnbellum.. 

Hemorrliase  into  cerebrum . . . 

Hemorrhage  Into  joint,  non- 
traumatic  

Hemorrhage  into  labyrinth . . . 

Hemorrhage  into  medulla. . . . 

Hemorrhage  into  parathyroid 
gland 

Hemorrhage  into  pons 

Hcmon'iagi  i(iio  relina 

Hemorrhage  into  suprarenal 
gland 

Hemorrhage,  subdural 

Hemorrhage  under  conjunctiva, 
Tumtraumatic 

Hemorrhoids 

Hemoihorai 

Hernia,  epigastrif 

Hernia,  femora! '. ". 

Hernia,  inguinal - 

Hernia,  internal 

Hernia,  ischiatlc 

Hernia,  ischiorectal '.  -' — 

Hernia,  lumbar 

Hernia,  obturator 

Hernia  of  brain 

Hernia  of  lung 

Hernia  of  (muscle, fascia,  ten- 
don, or  sheath) — 

Hernia,  umbilical -■••.-'■• 

Hernia,  ventral 

Herpes •-■ 

EUxmigh 

Histoplasmosis 

Hodgicin's  disease 

Hordeolum 

Hydrocele  of  spermatic  cord . . 

Hydrocele  of  tunica  vagiiui'.is.. 

Hydrocephalus,  acquired 

Hydronephrosis 

Hyperestnesia  of  retina 

Hyperchylia,  gastric 

Hyperemia  of  conjunctiva — 

Hyperidrosis 

Hypermetropia 

Hypernephroma 

Hypertrophy  of  bone 

tiypntro^hy  of  heart 

Hypertrophy  of  mammary 
gland 

H  ypertrophy  of  tonsU 

Hypochlorhydria 

Hypochotidriasis 

Hypopyon 

H  ysteria 

Ichthyosis 

Imbecilitv 

Impactoa  feces 

Impetigo  contagiosa 

Impetigo  herpeliformis 

Impetigo  simplo.x 

Impotence 

Incnniinmce  of  urine 

Infarct  of  Widney 

Infarct  of  lung 

Infarct  ol spleen. ...,,,,.,... 


I 
XIV 
XIII 

III 
XIII 
XIII 

xn 

V 

xm 

IV 

xni 

VI 

IV 
XIII 

VI 

ni 
xrv 

XVI 
XVI 

x\a 

XVI 

XVI 
XVI 
XVI 
XVI 
XIII 

xrv 

XII 
XVI 
XVI 

XV 

xm 
vui 

X 
VI 
VII 
VII 
XIII 
VII 
VI 

in 

VI 
XV 
VI 
XIX 

xu 
n 

Kvn 
III 
III 

XIII 
VI 

XIII 
XV 
XI 

in 

XV 
XV 
XV 
VIT 
VII 
VII 
XIV 
.IV 


Interna- 
tional No. 


55 

98 
64 
HOB 
G4 
H4 

147 
76 
64 

85 

64 

75C 

85 
64 

76C 
83 
93 
109 
109 
109 
109 
109 
109 
109 
109 
74 


149 

109 

109 

145C 

74 

55 

53A 

75C 

127 

127 

74 

122 

75C 

103 

75C 

145C 

75C 

45E 

146 

79C 

133 
100 
103 
6S 
75C 
73A 

i45r 

74 

lion 

1451 

145C 

145 

127 

124 

m 

94 
IIU 


Inflammation     of     salivary 

gland 

Inflammation    of    spermatic 

cord 

Influenza 

Ingrowing  nail 

Ivto  mnia 

InsufTiciency  of  ocular  muscle. 

Intertrigo 

Iridochoroiditit 

Iridocyclitis 

Iritis 

Jaundice,      acute     infecti%  r; 

(Weil's  disease) 

Kala-azar 

Keratitis 

KeratitLs,  phlyctenular 

Keratodermia 

Koratoiritis 

Keratosis 

Lan-a  migrans 

Laryngitis,  acute 

Laryngitis,  chroni? 

Lentigo 

Leontiasis  ossea 

Leprosy 

Leukemia 

Loukodermia 

Leukokeratosis 

Leukoma 

Lichen,  planus 

Lichen,  ruber , 

Lipemia 

Lipoma 

Locomotor  ataxia 

Loose  bodv  in  joint 

Loss  of  substance  of  (bone  or 

cartilage) 

Lupus,  erythematosus 

I  Lymphacfenltls,  acute 

I  Lymphadenitis,  chronic , 

j  LymphangiectasLs 

Lymphangioma 

Lymphangitis 

Lymphoma 

Malaria 

Malformations,  congenital. . . 

Malingering 

Mallet  linger 

Malnutrition 

Mastoiditis,  acute 

Mastoiditis,  chronic 

Masturbation 

Measles 

Mediastino-pericarditis 

MelannhoMa,  involutional 

Melaiiodermia 

M^niftre's  disease 

Meningitis,  cerebral 

MenlngilLs,  a>rebrospinal.... 

Meningitis,  spinal 

Motastrongylus  apri 

Metatarsalgia 

Migraine 

Mikulicz's  disease 

Miliaria 

Miliary  fever 

Milium 

Milk  slckn&ss 

Mixed  benign  tumor 


Navy 
class  No. 


Interna- 
tional No. 


m 

VII 
VIII 

XV 
XVII 

VI 

XV 

VI 

VI 

VI 

VIII 
VIII 
VI 
VI 
XV 
VI 
XV 
XVIIT 
XIV 

xrv 

XV 
XII 
VIII 

I 

XV 

XV 
VI 
XV 
XV 

xvn 

XIX 
XIII 
XII 


99B 

127 
10 

145C 
1S9A 

75C 
145C' 
75C 
75C 
75C 

111 
54 

75C- 

75C 
145C 

75C 
145C 
145C 


145C 

146 

17 

5.3( 

145( 

145C- 

75C 

145' 

145f 

121 

4b 

62 

147 


xn 

14t. 

XV 

1451 

X 

84 

X 

8-1 

X 

84 

XIX 

4b 

X 

84 

XIX 

46 

VUI 

4 

XVII 

150 

XVII 

189B 

XII 

149 

XV  u 

189A 

V 

146 

V 

146 

VII 

74 

VIII 

6 

II 

77 

XI 

68 

XV 

145( 

XIII 

76 

XIII 

61 

XIII 

61 

XIII 

61 

XVIII 

107 

XI I 

149 

XVII 

74 

XV 11 

g9U 

XV 

145( 

VIII 

U 

XV 

145C 

xvn 

19 

XJX 

46 

MANUAL   FOR    THE   MEDICAL  DEPARTMENT,   U.   S,    NAVV.        183 
Section  11. — Diseases — Continued. 


Mixed  malignant  tumor 

Molluscum  contagiosum 

Mucormycosis  

Mumps 

Myasthenia  gravis 

Mycetoma 

Mycosis  f ungoides 

Myelitis,  disseminated 

Myelitis,  transverse 

Myiasis 

Myocarditis,  acute 

Myocarditis,  chronic. 

Myoma 

Myopia 

Myositis,  acute 

Myositis,  chronic 

Myositis,  progressive  ossifying 

Myositis,  traumatic  ossifying. . 

Myotonia  congenita 

Myringitis,  acute 

Myrinsitis,  chronic 

Myxedema 

Myxoma 

Nausea  marina 

Necrosis 

Nephralgia 

Nephritis,  acute 

Nephritis,  chronic  interstitial. 

Nephritis,  chronic  parenchy- 
matous   

Nephritis,  disseminated,  sup- 
purative  

Nephrolithiasis 

Nephroptosis 

Nervous  dyspepsia 

Neuralgia 

Neurasthenia 

Neuritis 

Neuritis,  multiple 

Neuritis,  optic 

Neuroma 

Neuroretinitis 

Neurosis,  intestinal 

Neurosis,  occupational 

Neurosis  of  bladder 

Neurosis  of  la  rynx 

Neurosis  of  pharynx 

Neurosis,  traumatic 

Nevus 

Night  blindness 

No  disease 

Nostalgia 

Nystagmus 

Obesity 

Obstruct  ion ,  acute  intestinal . . 

Obstruction,  chronic  intestinal 

Obstruction  of  pancreatic  duct 

Obstruction  oj  portal  vein 

Ochronosis 

Odontoma 

Onychauxis 

Onych  ia 

Onychoma 

Opacity  of  vitreous  humor 

Ophthalmoplegia 

Orchitis,  acute  (nonvenereal). 

Orchitis.chronic  (nonvenereal)j 

Oriental  sore I 

Ossification  of  auricle ] 

Ossification  of  cartilage,  uiv- 
qualified I 


Navy 
class  No. 


XIX 
XV 

xvin 

VIII 
XIII 

XVIII 
XV 
XIII 
XIII 

XVIII 

II 
II 

XIX 

VI 
XII 
XII 
XII 
XII 
XII 

V 

V 

IV 
XIX 
XVII 
XII 
VII 
VII 

vn 
vn 

vn 

VII 

VII 

III 

XIII 
XIII 

xm 

XIII 

VI 
XIX 

VI 

m 
xni 
vn 

XIV 

III 

XIII 

XV 

VI 
XVII 
XVII 

VI 
XVII 

III 
III 
III 
III 

XVII 
XIX 

XV 

XV 

XV 

VI 

VI 

VII 

VII 

vm 

V 
XII 


Interna- 
tional No. 


39-45 

145C 

25B 

19 

63 

25B 

25B 

63 

63 

145  ' 

78 

79,; 

40 

75-; 

149 
149 
149 
149 
149 
76 
76 


189  A. 
146 
122 
119 
120 

120 

122 

123 

122 

103 

73  B 

74 

73  B 

73  B 

76C 

46 

75C 

IlOB 

74 

124 

87 

100 

74 

150 

75C 

189A 

68 

75C 

65 

109 

109 

118 

115 

55 

46 

145C 

145C 

145C 

75C 

75C 

127 

127 

145C 

76 

149 


Ossification  of  larynx 

Ossification  of  tracheal  rtogs.. 

Osteitis  deformans 

Osteoarthropathy,  hypertro- 
phic  

Osteoma 

Osteomalacia 

Osteomyelitis ,  acute 

Osteomyelitis,  chjonic 

Otitis  externa 

Otitis  interna,  acute ..'.. 

Otitis  interna,  chronic 

Otitis  media,  acute 

Otitis  media,  chronic , 

Oxyuriasis 

Ozena 

Pachymeningitis,  cerebral 

Pachymeningitis,  spinal , 

Palpitation,  cardiac 

Pancreatitis,  acute 

Pancreatitis,  chronic 

Panophthalmitis 

Papilloma 

Pappataci  fever 

Paragonimiasis 

Paralysis,  acute  ascending 

Paralysis,  agitans 

Paralysis,  Brown-Sequard's.. 

Paralysis  of  nerve 

Paralysis  of  ocular  muscle 

Paralysis  of  vocal  cords 

Paralysis,  muscle,  ischemic. . . 

Parameba  hominis 

Paramyoclonus  multiplex 

Paranoia 

Paranoiac  state 

Paraphimosis 

Paraplegia,  ataxic 

Paratyphoid  fever 

Pediculosis 

Pellagra 

Pemphigus 

Perforated  nasal  septum 

Pericarditis 

Pericardium,  adherent 

Perichondritis  of  auricle 

Perichondritis  of  larynx 

Perihepatitis 

Periostitis,  acute 

Periostitis,  chronic 

Perisplenitis 

Peritonitis,  acute,  general 

Peritonitis,  acute,  local 

Perilovilis,  chronic,  general 

Peritovitis,  chronic,  local 

Persistent  thymus  gland 

Perversion  ol  appetite 

Pes  ca  vus 

Pes  planus 

Phantom  tumor 

Pharyngitis,  acute 

Pharyngitis,  clironie 

Phimosis 

Phlebitis 

Piedf  a 

Pinta 

Pityriasis  rosea 

Pityriasis  simplex 

Pityriasis  versicolor 

Plague 

Pleurisy,  acute  fibrinous 


Navy 
class  No. 


XIV 
XIV 
XII 

xvn 

XIX 
XII 
XII 
XII 

v 
v 
v 

V 
V 

xvni 

XIV 
XIII 
XIII 

II 
III 
III 

VI 
XIX 
VIII 
XVIII 
XIII 

xin 

XIII 
XIII 
VI 
XIV 
XII 
XVIII 

xm 

XI 
XI 

VII 
XIII 
VIII 
XVIII 
VIII 
XV 

xrv 

II 

II 

v 
xrv 

in 

XII 

xn 

IV 

in 
III 
III 
III 

IV 

III 
xu 

XII 
XVII 

III 
III 

VII 

II 
xvin 

XVIII 

XV 

XV 
XVIII 

VIII 

xiv 


Interna- 
tional No. 


146 

36B 

46 

36A 

146 

146 

76 

76 

76 

76 

76 

107 

86 

61 

61 

85 

118 

118 

75C 

46 

19 

107 

63 

63 

63 

66 

75C 

74 

149 

107 

74 

68 

68 

127 

66 

1 

145(: 

26 

145C 

86 

77 

77 

76 

87 

115 

146 

146 

116 

117 

117 

117 

117 

84 

103 

149 

149 

189B 

100 

100 

127 

83 

2aB 

253 

145C 

145C 

25B 

15 

03 


184        MANUAL  FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 
Section  11. — Diseases — Continued. 


Plenrisy,  chronie  fibrinous 

Pleurisy,  serofibrinous 

Pleurisy,  suppumtive 

Pleuritic  adiiesions 

Pneumatocele  capitis 

Pneumonia,  broncho- 

Pneumonia,  interstitial 

Pneumonia,  lobar 

Pneumonoconiosis 

Pneumopericardium 

Pneumophagia 

Pnevmothorai 

Poliomyelitis,  acute  anterior.. 

Poliomyelitis,clironic  anterior 

Poliomyelitis,  acute  bulbar... 

Polycyihcmin,  chronic 

Polypus,  nasal 

Presbyopia 

Proctalgia 

Proctitis 

Prolapse  of  rectum 

Prostatitis,acute(nonven(!real> 

Prostatitis,  chronic  (nonvene- 
real) 

Prurigo 

Pruritus 

Psoriasis 

Psychasthenia 

Psychosis,  due  to  organic 
brain  disease 

Psychosis,  epileptic 

Psychosis  (exhaustive,  infect- 
ive, and  toxic) 

Psychosis,  hysterical 

Psychosis,  intoxication 

Psychosis,  manic  doj>ressive. . 

Psychosis,  polyneuritic 

Psychosis,  senile 

Psychosis,  traumatic 

Pterygium 

Purpura 

Purpura,  hemorrhagic 

Pyelitis 

Pyelonephritis 

I*yeleph  lebitis 

Pyloric  incontinence 

Pylorospasm 

Pyopneiimonericardium 

Pyopneumntnoraz 

Pyorrhoea,  alveolar 

Rabies 

Raynaud's  disease 

Redundant  prepuce 

Redimdant  scrotum 

Regurgitation  of  stomach 

Relapsing  (over 

Retention  cyst 

Retinitis 

Jlheumatic  fever,  acute 

liheumatir  lever,  subacute. . . 

lUieurnatism,  chronic  articu- 
lar  

Rheumatism,  muscular 

Rhinitis,  acute 

Rhinitis,  atroi)hic 

Rhinitis,  hypertrophic 

Rhinolith 

Rhinoscleroma 

Rickets 

Rocky  Nfountain  spot  ted  fever. 

Rosacea 


Navy 
class  No. 

Interna- 

tional No. 

XIV 

gs 

XIV 

93 

XIV 

93 

XIV 

93 

XIV 

145C; 

XIV 

91 

XIV 

98 

XIV 

92 

XIV 

98 

II 

77 

III 

103 

XIV 

93 

VIII 

63 

VIII 

63 

VIII 

63 

I 

55 

XIV 

46 

VI 

75C 

III 

110  A 

III 

llOA 

III 

HOB 

VII 

126 

VII 

126 

XV 

145C 

XV 

145C 

XV 

145C 

XI 

68 

XI 

74 

XI 

69 

XI 

68 

XI 

73A 

XI 

68 

XI 

68 

XI 

68 

XI 

154A 

XI 

68 

VI 

75C 

I 

55 

I 

55 

VII 

122 

VII 

122 

III 

83 

III 

103 

III 

103 

11 

77 

XIV 

93 

111 

99A 

\11I 

23 

XVII 

142 

Vll 

127 

VII 

127 

III 

103 

VIII 

3B 

XIX 

46 

VI 

75C 

Vlll 

47 

VIII 

47 

XVII 

48B 

XVII 

149 

XIV 

86 

XIV 

86 

XIV 

86 

XIV 

86 

XV 

86 

XVII 

360 

VIII 

19 

XV 

145C 

Rumination 

Rupture  of  esophagus,  spon- 
taneous   

Rupture  of  heart,  spon  tancous 

Rupture  of  spleen,  spontane- 
ous  

Sarcoma , 

Sarcopsiliasis , 

Scabies 

Scarlet  fever 

Schistosomiasis,  intestinal 

Schistosomiasis,  urinary 

Scleritis 

Scleroderma 

Sclerosis,  amyotroi)hic  lateral 

Sclerosis,  disseminated 

Sclerosis,  lateral 

Sclorosisofcorpuscavemosum 

Scurvy 

Seborrhea 

Seminal  emisrions 

Senility , 

Septicemia 

Shock , 

Sinus 

Sinusitis,  ethmoidal , 

Sinusitis,  frontal , 

Sinusitis,  maxillary 

Sinusitis,  sphenoidal , 

Smallpox , 

Snov/  blindness , 

Somnambulism 

Spasm  haliit 

Spasm  nodding , 

Spasm  of  esophagus 

Spasm  0/  rectum , 

Spasm  saltatory; 

Spermatocele 

Spermatorrhea 

Splanchnoptosis 

Splenitis,  acute , 

Splenitis,  chronic  interstitial.. 

Splenoptosis 

Sporotrichosis 

Sprue 

Spur  on  nasal  septum 

Stammering 

Staphyloma  of  cornea 

Status  lymphaticus 

Stenoxis  of  brunch  us 

Stenosis  of  gall-duct 

Stenosis  of  lir;ini 

Stenosis  of  nasal  duct 

Stenosis  ofjninctum  lacrimale. 

Stenosis  of  pi/loru-s 

Stenosis  of  trachea 

Sterility 

Stoniat  i  lis 

Stomatitis,  pangreiious 

Stricture  of  rsophagns 

Stricture  of  inUsfinf 

Stricture  of  pharynx 

Stricture  of  rectum 

Stricture  of  ureter 

Stricture  of  urethra 

Strongyloides,  intestinal 

Strongylus  gibsoni 

Stuttering 

Sudamina 

Suppression  of  urine 


Navy 
class  f5o. 


lU 


Interna- 
tional No. 


103 


III 

101 

II 

79C 

IV 

116 

XIX 

39-45 

XVIII 

145C 

XVIII 

145B 

VIII 

7 

XVIII 

107 

XVIII 

122 

VI 

75C 

XV 

145C 

XIII 

63 

XIII 

C3 

XIII 

63 

VII 

127 

XVII 

49 

XV 

145C 

VII 

127 

XVII 

154B 

VIII 

20 

XVII 

189A 

XVII 

145C 

XIV 

146 

XIV 

146 

XIV 

146 

XIV 

146 

VIII 

5 

VI 

75C 

XIII 

74 

XIII 

74 

XIII 

74 

111 

101 

III 

HOB 

XIII 

74 

VII 

127 

VII 

127 

HI 

HOB 

IV 

116 

IV 

116 

IV 

116 

XVIII 

25B 

III 

HOB 

XIV 

86 

XUI 

74 

VI 

760 

X 

84 

XIV 

98 

111 

115 

XIV 

87 

VI 

750 

VI 

750 

in 

103 

XIV 

08 

VII 

127 

III 

99B 

III 

142 

III 

101 

III 

109 

III 

100 

Ttl 

HOB 

VII 

122 

vir 

123 

XVIII 

107 

XVIII 

107 

XIU 

74 

XV 

14.50 

VII 

124 

MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.    S.    NAVY.       185 

Section  11. — Diseases — Continued, 


Symblepharon 

Synechia 

Syphilis 

Syringomyelia 

Tachycardia 

Talipes 

Teriasis 

Tenosynovitis 

Teratoma 

Tetanus 

Tetany 

Thrombosis 

Thrush 

Thyroiditis,  acut« 

Thyroiditis,  chronic 

Tic,  convulsive 

Tic,  coordinated 

Tic,  psychical 

Tonsilitis,  acute  follicular 

TonsUitis,  chronic 

Torsion  of  omentum 

Torsion  of  spermatic  cord, 
nontraumatic 

Tracheitis 

Tracheocele 

Trachoma 

Trichiasis 

Trichiniasis 

Trichophytosis 

Trichostrbngylus  instabilis 

Trichuriasis 

Trichuris  trichiura 

Trigger  finger 

Trypanosomiasis 

Tuberculosis ,  abdom  inal 

Tuberculosis,  acute  broncho- 
pneumonic  

Tuberculosis,  acute  general . . . 

Tuberculosis,  acute  pneu- 
monic  

Tuberculosis,  acute  pulmon- 
ary miliary 

Tuberculosis,  chronic  pul- 
monary  

Tuberculosis  of  bronchus 

Tuberculosis  of  joint 

Tuberculosis  of  larynx 

Tuberculosis  of  pleura 


Navy 
class  No. 


VI 

VI 

IX 

XIII 

II 

XII 
XVIII 
XII 
XIX 
VIII 
XVII 

II 

XVIII 

IV 

IV 
XIII 
XIII 
XIII 

III 
III 
in 

VII 
XIV 

xrv 

VI 
VI 

xvin 

XVIII 
XVIII 
XVIII 
XVIII 

XII 
XVIII 

VIII 

VIII 

vni 
vin 
vin 
vra 

VIIi 
VIII 
VIII 
VIII 


Interna- 
tional No. 


75C 
75C 
37 
63 
85 
149 
107 
149 
46 
24 
74 
82 
99B 


74 
74 
74 
100 
100 
118 

127 


75B 

75C 

107 

145A 

107 

107 

107 

149 

65 

31 

29 
29 


Tuberculosis  of  spinal  column 

Tuberculosis  of  trachea 

Tuberculosis  unqualified 

Tuberculous  meningitis 

Typhoid  fever 

Typhus  fever 

Ulcer  of  bladder 

Ulcer  of  bronchus 

Ulcer  of  duodenum 

Ulcer  of  epidottis 

Ulcer  of  eye  and  adnexa 

Ulcer  of  intestines 

Ulcer  of  mouth 

Ulcer  of  nasal  passage. 

Ulcer  of  rectum 

Ulcer  of  skin 

Ulcer  of  stomach 

Ulcer  of  trachea 

Ulceromembranous  angina 

Uncinariasis 

Undulant  fever 

Union  of  fracture  faulty 

Ureteral  colic 

Ureteritis 

Urethritis,    acute    (nonven- 

ereal) 

Urethritis,  chronic  (noavon- 

ereal) 

Urticaria 

Urt  icaria  pigmentosa 

Vaccinia 

Valvular  disease,  chronic  car- 
diac  

Varicocele 

Varix 

Veldt  sore 

Verruca  peruana 

Vertigo 

Vom  iting,  recurrent 

Wart 

^V'^looping  cough 

Xanthoma 

Xeroderma  pigmentosa 

Xerosis 

Xerostomia 

Yaws 

Yellow  fever 

Z  oster 


Navy 
class  No. 


Vin 

VIII 

vin 

VIII 
VIII 
VIII 
VII 
XIV 

III 

XIV 
VI 

III 
III 

XIV 

III 

XV 

in 

XIV 

III 

XVIII 
VIII 
XII 

vn 

VII 

VII 

VII 
XV 
XV 
VIII 

II 

VII 

II 

VIII 

VIII 
XVII 

m 

XV 
VIII 
XV 
XV 
VI 

III 

VIII 
VIII 
XIII 


Interna- 
tional No. 


32 

28 

34 

30 

1 

2 

124 

9S 

105A 

87 

75C 

105B 

99B 

86 

HOB 

145C 
102 
98 
100 
108 
3A 
146 
123 
122 

125 

125 

146C 

145C 

19 

79A 

83 

83 

145C 

55 

189A 

103 

145C 

8 

14.5C 

145C 

75C 

99B 

19 

16 

145C 


2360. 


Section  12. — Injury  (Wounds,  etc.). 


Injury. 


Abrasion  Cstate  site) 

Air  embolism  (state  site) 

Avulsion  (state  part) 

Blood  donor 

Bum  (state  site) 

Castration,  traumatic 

Compression  (state  part). 
Contusion  (state  part) . . . 

Crush  (state  part) 

Decapitation 

Deprivation  of  water 


Navy 

Interna- 

class No. 

tional  No. 

XX 

186 

XX 

186 

XX 

186 

.XX 

189B 

XX 

167 

XX 

1S6 

XX 

186 

XX 

186 

XX 

186 

XX 

186 

XX 

177B 

Injury. 


Diagnosis  undetermined 

Dislocation  (state  articulation) 
Drowning  (fatal  submersion).. 
Electric  shuck,  injury  from. . . 
Emphysema,traumatic  (state 

site) 

Epilation,    traumatic    (state 

site) 

Epiphyseal  separation  (state 

bone) 

Exhaustion  from  heat 


Navy 
class  No. 


XX 
XX 
XX 
XX 

XX 

XX 

XX 
XX 


Interna- 
tional No. 


185A 

169  B 

181 

1S6 

186 

1850 
179A 


186         MANUAL  POB   THE   MEDICAL   DEPARTMENT,   U.    S.   NAVY. 
Section  12. — Injubt  (Wounds,  istc.) — Continued. 


Injwy. 


Na%'y 
class  No. 


Exhaustion  from  overexert  !on 

Exhaustion  from  overexposure 

Foreign  body,  traumatic  (state 
site) 

Fracture  (state  bone),  com- 
pound   

Fracture  (state  bone),  simple 

Fracture  of  penis 

Frostbite  (state  part) 

Heat  cramps 

Hematocele,  tunica  vaginalis, 
traumatic 

Hematoma  (state  site),  trau- 
matic  

Hemorrhage     into     eyeball, 
traumatic 

Ilemorrhaee  Into  (state)  joint, 
traumatic 

Hemorrhage  under  conjuno- 
tlva,  traumatic 

Intracranial  injury 

Intraspinal  Injury 

l-ightning  strok-e 

Multiple  injuries,  extreme 

Powdered  glass.  Injury  from  I 
swallowing 


XX 
XX 

XX 

XX 
XX 
XX 
XX 
XX 

XX 

XX 

XX 

XX 

XX 
XX 
XX 
XX 
XX 

XX 


Interna- 
tional No. 


177A 
177A 

186 

1850 

185C 

186 

178 

179A 

127 

186 
186 


186 
186 
186 
180 
186 

186 


Injury. 


I     Navy 
class  No. 


Rupture  (state  organ  or  part), 
traumatic  (not  to  be  uicd 
for  hemiiB,  q.  v.,  under  dis- . 
eases) 

Skin  donor 

Smoice  inhalation ,. . . 

Sprain  (state  joint) 

Starvation 

Strain  (state  muscle) , 

I  Strangulation 

;  Strangulation  of  penis 

'  Submersion  (nonfatal) 

Sunburn  (state  site) 

Sunstroke 

Synovitis  (state  joint),  trau- 
matic  

Thermic  fever 

Torsion,  spermatic  cord,  trau- 
matic  

Urethal  fever,  traumatic 

Wound,  gunshot  (state  site).. 

Wound,  incised  (state  site). . . 

Wound,  lacerated  (state  site).. 

Woimd,  punctured  (state  site; 


XX 

XX 
XX 
XX 
XX 
XX 
XX 
XX 
XX 
XX 
XX 

XX 
XX 

XX 
XX 
XX 
XX 
XX 
XX 


Interna- 
tional No. 


18«i 

189B 

16815 

ISoll 

177Ii 

186 

186 

186 

169A 

167 

179B 

186 
179A 

186 

12i-. . 

170 

171 

186 

171 


23C1. 


Section  13. — Injury  (Poisons). 


Poison. 


Botulism 

Creatoxism 

Diagnosis  undetermined 

Insect  sting..... 

l^athyrism 


Navy 

class  No. 


XXI 
XXI 
XXI 
XXI 
XXI 


Interna- 
tional No. 


164 
164 


165A 
69 


Poison. 


Poison  (state  anaesthetic), 
ansethesia 

Poison  (state  substance  and 
whether  acute  or  chronic). . 


Navy 

class  No. 


XXI 
XXI 


Interna- 
tional No. 


16.SB 


.Section  14.- 


-Instructions  Rexating  to  the  Preparation  of  Statistical  Re- 
poet  (Form  K). 


2871.  It  shall  be  prepared  and  forwarded  with  Forms  F  (rough)  and  F,  for 
a  whole  or  fraction  of  the  quarters  ending  March  31,  June  30,  September  30, 
and  December  31  of  each  year,  and  when  a  hospital,  ship,  or  station  is  placed 
out  of  commission. 

2372.  It  shall  be  typewritten  and  a  copy  retained  for  the  transmitting  oflice 
flies.  A  copy  shall  be  forwarded  to  the  senior  fleet  or  siiuadron  surgeon  when 
serving  In  a  fleet  or  squadron.     lUbbDU  copy  to  be  forwarded  to  the  bureau. 

2373.  If  there  have  been  "  no  sick  "  during  the  period  covered  by  this  report, 
it  shall  be  so  stated  In  the  space  under  "disabilities." 

2876.  The  report  shall  include  all  offlcers  and  men  of  the  Navy  and  Marine. 
Corps,  and  tho.se  of  the  native  and  insular  forces  on  the  active  list;  not  super- 
numeraries (retired  ofHcers  and  men,  officers  and  men  of  the  Naval  Auxiliary 
.Service  and  Nur.so  Corps  (female),  and  others).  A  separate  Form  K  for  super- 
numeraries Is  not  required. 

2377.  "  Date  commlss^loned  "  shall  always  be  carefully  statetl. 


MANUAL   FOE   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        187 

237S.  '■  Date  out  of  commission  "  will  be  eatered  as  occasion  requires,  other- 
wise left  blank. 

2379.  ''Average  complement  "  shall  be  obtained  by  dividing  tlie  total  number 
oX  daily  rations  issued  and  commuted  during  the  quarter  or  fraction  of  a 
quarter  embraced  in  this  report  by  the  number  of  days  in  the  quarter  or  frac- 
tion of  the  quarter,  as  the  case  may  be,  but  the  average  number  of  officers  to 
whom  rations  are  not  allovped  must  be  adde<i.  (Number  of  rations  issued  and 
commuted  may  be  obtained  from  the  pay  officer.)  Ships,  stations,  and  yards 
will  not  include  in  their  average  complements  officers  and  men  attached  (on 
duty  or  as  patients)  to  a  naval  hospital.  Naval  hospitals  will  give  as  an  aver- 
age complement,  officers  and  men  attached  (on  duty  or  as  patients)  to  the 
hosj)ital. 

2380.  "  Inoculations  "  shall  show  the  number  of  men,  not  times,  inoculated. 
2383.  "Disabilities":   (a)  The  data   for  this   report  shall  be  taken   from 

Form  F  (rough),  upon  which  the  necessary  entries  shall  have  been  made  from 
the  health  record.  (6)  The  sum  total  of  the  "  remaining  from  last  year,"  "  ad- 
mitted," and  "  readmitted "  shall  balance  with  the  sum  total  of  the  other 
columns,  excluding  that  of  "  number  of  sick  days,"  and  all  totals  shall  be  iden- 
tical with  Form  F  (rough). 

2387.  "Summary  of  cruise":  The  summary  of  cruise  is  required  from  all 
vessels,  except  receiving  ships,  whether  in  reserve,  with  Naval  Militia  or  not. 
and  the  fact  of  being  in  one  port  for  a  whole  quarter  does  not  change  this 
requirement.  Expeditions  or  detachments  of  any  nature  should  use  this  space 
to  report  their  movements,  giving  dates  of  arrival  and  departure  from  any  ves- 
sel or  place  (town  or  country)  in  which  they  may  be  operating. 

2388.  Dental  report  shall  be  prepared  by  the  dental  officer.     (Par.  1037.) 

2389.  "  Summary  of  cruise  "  is  for  cruising  vessels  only. 

2390.  "  Personnel "  will  be  filled  in  as  called  for  in  the  columns  as  noted. 
2891.  A  separate  Form  K  for  supernumeraries  is  not  required. 

Section    15. — Regulations    Govebning    Bepobts    ok    Death,    and    Boabds    of 

Inquest. 

2401.  Gratuity  pay  to  designated  beneficiary.     R  2902  (5)  ;  R  4551  (1). 

2402.  J"'unera]  expenses  of  an  officer.  R  4551  (2).  Urgent  deficiency  act, 
June  15,  1917. 

2403.  Expenses  of  iutennent    R  4551  (3-4). 

2404.  Public  bill  for  funeral  expenses.    R  4551  (4-5). 

2405.  Transportation  of  remains,  expenses.    R  4551  (5-10). 

2406.  Accounts  of  deceased.    R  4552. 

2407.  Report  of  funeral  expenses.    R  4553. 

2408.  Report  of  death  prepared  in  duplicate  and  one  additional  copy  for 
commander  in  chief  and  fleet  surgeon.  R  2963  (1)  ;  I  5335  (8)  ;  I  1122  (8)  i' 
I  5247  (36). 

2409.  Determination  of  line  of  duty  on  report  of  death.    R  2963  (2). 

2410.  Report  of  death  required  as  evidence  for  claiming  pension.    R  4562. 
^  2411.  Line  of  duty  in  cases  of  death  where  record  is  incomplete.    R  4564. 

'r'  2412.  Deaths  to  be  entered  in  the  ship's  log.    R  2119  (1). 

'  2413.  Deaths  to  be  reported  to  department  and  next  of  kin.    R  2119  (2). 

.  2414.  EfTects  of  deceased  persons  to  be  collected  and  inventoried.    R  2119  (3) . 

2415.  Perishable  effects  to  be  sold  at  auction.    R  2119  (4). 

2416.  Papers,  etc.,  of  the  deceased  to  be  sent  to  legal  representative  or  to' 
department,  or  Commandant,  Marine  Corps.     R  2119  (5-6). 

2417.  Discretion  as  to  disposition  of  deceased's  effects.    R  2119  (7). 

:  2418.  Commanding  officer  to  sign  descriptive  list  on  report  of  death.    R  2120. 

2419.  Boards  of  inquest  to  be  ordered  in  all  cases  of  death  from  accident, 
etc.     R  321  (1).  i 

2420.  At  least  one  medical  officer  to  be  on  board  of  inquest.    R  321  (2). 

2421.  Duties  and  procedure.    R  322. 


188        MANUAL  FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

2422.  Opinion  of  medical  officer  as  to  cause  of  death  required.    R  322  (3). 

2423.  I )outh  from  violence.     R  322  (4). 

2424.  Form  of  record  of  proceedings  as  authorized.    R  323. 

2425.  Statement  of  opinion  as  to  line  of  duty  and  whether  death  due  to  dis- 
ease or  injury  not  the  result  of  misconduct.     R  323  (2). 

242({.  Court  of  inquiry  on  accidents  causing  loss  of  life.    R  401  (2). 

Section  16. — General  Information  Regarding  Reports  of  Death  (Form  N.) 

2431.  The  laws  and  regulations  for  the  government  of  the  Navy  require  that 
a  record  shall  be  made  of  all  persons  whose  deaths  occur  in  the  naval  service, 
li  20  (3).  These  reports  are  required  as  evidence  in  claims  for  pension  and 
to  determine  the  right  of  beneficiaries  to  gratuity  pay.     R  4551 ;  R  45C2. 

2432.  A  report  of  death  on  the  prescribed  form  shall  be  made  out  in  duplicate 
in  all  cases,  and  shall  be  forwarded,  through  official  channels,  to  the  Bureau  of 
Medicine  and  Surgery.  From  ships  in  the  fleet  one  copy  is  marked  for  the 
commander  in  chief,  for  approval  by  the  fleet  surgeon.     R  2963;  I  1122  (8). 

2433.  In  the  case  of  the  death  of  an  officer  reports  are  prepared  in  triplicate, 
with  an  additional  copy  for  the  commander  in  chief  (and  fleet  surgeon). 

2434.  In  addition  to  the  record  contained  In  the  health  i-ecord  relating  to  the 
case  of  an  officer  or  enlisted  man  of  the  Navy  or  Marine  Corps  whose  death 
occurs  on  board  ship,  the  name,  rank,  and  rate,  and  the  time  of  his  death  shall 
be  fully  entered  on  the  ship's  log  (R  2119  (1)),  and  in  the  journal  of  the 
Medical  Department. 

2435.  A  report  of  the  death  of  an  officer  of  the  Navy  or  Marine  Corps  who 
dies  while  on  leave,  waiting  orders,  or  on  special  duty,  and  who  was  not  under 
the  professional  care  of  a  medical  officer  of  the  Navy,  shall  be  requested  from 
the  physician  who  attended  such  officer  during  his  last  illness.  Upon  the  receipt 
by  the  bureau  of  the  report,  a  report  of  the  death  will  be  prepared  and  signed 
by  the  Surgeon  General. 

243(J.  Whenever  an  officer  or  enlisted  man  of  the  Navy  or  Marine  Coi-ps  who 
is  not  under  the  professional  care  of  a  medical  officer  of  the  Navy  dies  in  a 
civil  lidspital,  at  home,  or  abroad,  a  report  of  his  death  should  be  required  from 
the  proper  authorities  in  charge  and  upon  its  receipt  by  the  bureau  a  report 
of  death  will  be  prepared  and  signed  by  the  Surgeon  General.     (R  4564.) 

2437.  Reports  of  death  in  the  cases  of  officers  and  men  on  the  retired  list  of 
the  Navy  and  Marine  Corps  shall  be  prepared  by  the  medical  otHcer  in  charge 
and  forwarded  to  the  Bureau  of  Medicine  and  Surgery.  In  the  event  of  any 
such  officer  or  man  not  being  under  the  professional  care  of  a  niedii-al  officei- 
of  the  Navy  at  the  time  of  his  death,  the  statement  of  the  civil  practitioner 
who  attended  iiim  during  his  last  illness  will  be  accepted,  and  upon  its  receipt 
by  the  bin-eau  a  report  of  death  shall  be  prepared  and  signed  by  the  Surgeon 
General. 

243H.  I'pon  the  receipt  by  the  bureau  of  the  offici-.il  notification  of  the  deatli 
of  an  oflicer  or  enlisted  man  of  the  Navy  or  Marine  Corps  in  St.  Elizabeths 
Hospital  for  the  Insane,  a  report  of  deatli  will  be  prepared  in  the  bureau,  upon 
information  supplied  by  that  institution,  and  signed  by  the  Surgeon  General, 
except  that  when  a  medical  officer  is  assigned  to  duty  in  tliis  institution  It  shall 
be  his  duty  to  prepare  and  forward  all  such  reports  of  death. 

243<).  Upon  the  receipt  of  the  official  notification  by  the  commandant  of  the 
navy  yard.  Mare  Island,  Cal.,  of  the  deatli  of  an  oflicer  or  enlisted  man  of  the 
Navy  or  Marine  (Jorps  in  a  State  hospital  for  insane.  California,  lie  shall 
cause  a  rcjiort  of  deatli  to  be  prepared  by  a  medical  officer  under  Ids  command. 

2440.  All  mortuary  reports  (life  insurance)  are  prepared  by  the  lUireau  of 
Medicine  and  Surgery,  and  the  necessary  data  for  the  preparation  of  such 
records  are  l)aseil  upon  information  coiitainetl  in  the  reports  of  death  on  file 
in  the  bureau. 

2441.  Tlie  regiUations  specify  that  in  all  cases  of  death  where  the  official 
record  may  be  Incomplete  the  Surgeon  General  shall  decide  as  to  whether  such 
death  occurrred  In  the  line  of  duty.     R  4504. 


MANUAL   FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.        189 

2442.  The  report  of  death  shall  contain  the  essential  facts  taken  from  the 
records  of  the  case,  without  giving  details  of  medical  treatment,  and  the  medi- 
cal officer  filling  out  the  report  shall  be  careful  to  state  whetlier  the  disease, 
injury,  or  disability  causing  death  did  or  did  not  originate  in  the  line  of  duty, 
basing  his  conclusions  upon  all  of  the  facts  in  his  possession.  If  the  command- 
ing officer  does  not  approve  of  the  origin  of  the  disease  or  injury  assigned  by 
the  medical  officer,  it  becomes  his  duty  under  the  regulations  to  indorse  on  the 
death  report  his  opinion  and  reasons  therefor.  R  2902  (5)  ;  R  29G3  (2)  ;  and 
R  4564. 

2443.  Post-mortem  examinations  and  autopsies :  In  all  cases  of  death  occur- 
ring in  the  Navy  attended  with  unnatural  or  suspicious  circumstances  or  where 
the  cause  of  death  is  obscure  or  not  apparent,  and  a  decision  as  to  origin  and 
line  of  duty  affecting  pension  or  gratuity  is  involved,  it  becomes  the  duty  of 
the  medical  officer  to  make  such  post-mortem  examination  or  autopsy  as  will 
enable  him  to  reach  a  conclusion  as  to  the  exact  cause  of  death.  In  all  such 
cases  the  autopsy  must  be  performed  in  a  manner  requiring  no  more  disfigure- 
ment of  the  body  than  is  necessary  to  obtain  the  evidence  desired  (R  4551  (7) ). 
The  results  of  all  autopsies  should  be  fully  recorded  in  reports  of  death,  health 
records,  and  in  the  journal  of  the  Medical .  Department. 

Section  16. — Embalming. 

2444.  When  the  services  of  a  professional  embalmer  can  not  be  obtainetl 
and  it  is  necessary  to  prepare  bodies  for  shipment  this  task  devolves  upon 
members  of  the  Medical  and  Hospital  Corps.  Full  directions  are  given  in  the 
Handy  Book  for  Hospital  Corps,  pages  175-178. 

The  fluid  recommended  is  prepared  by  the  following  formula : 

Formalin  ( 40  p.  c. ) mils__     12.  50 

Borax grams__      5 

Water  to  make mils__  100 

An  amount  of  this  fluid  corresi>onding  to  one  fifteenth  of  the  weight  of  the 
body  should  be  injected  into  the  arterial  circuit  (allow  493.50  mils  to  1  pound) 


08  [       Y 


CHAPTER  14. 


'SANITARY    REGUTATIONS    AND    REPORTS    AND    SANITARY    DUTIES. 

Section  1. — Navt  Reqitlations  and  Naval  Instructions  Relating  to  the 
Sanitabt  Duties  of  the  Medical  Depabtment. 

2501.  The  Medical  Department  is  charged  with  inspecting  the  sanitary  con- 
ditions of  the  Navy  and  making  recommendations  in  reference  thereto ;  advising 
the  department  regarding  sanitary  features  of  ships,  selection  of  hygienic  sites 
for  and  hygienic  construction  of  buildings,  barracks,  and  camps ;  advising  about 
water  supplies  and  drainage,  clothing  and  food,  in  so  far  as  these  influence 
health,  and  safeguarding  the  personnel  by  employment  of  the  best  methods  of 
hygiene  and  sanitation  afloat  and  ashore.    R  133;  R  2901  (1). 

2602.  The  Red  Cross  to  constitute  part  of  sanitary  service  of  uaval  forces. 
R  3861  (1). 

Section  2. — ^Naval  Instructions  Relating  to  the  Sanitary  Duties  of  the 

Commander  in  Chief. 

2511.  To  regulate  sanitary  duties  in  instructions  to  his  command.    I  902. 

2512.  To  inspect  hospitals  and  hospital  ships  within  his  command.  (R 
2918)  ;  I  908. 

2513.  To  report  infectious  or  contagious  diseases  among  ships  of  fleet. 
I  916  (3)r. 

2514.  Yearly  report  to  contain  sanitary  condition  of  command,  percentage  of 
sick,  number  of  deaths,  and  number  sent  to  hospital  and  invalided  home.  I  916 
i4)d. 

2516.  Precautions  on  unhealthful  statioas.    I  952  (1). 

2516.  Health  of  ports  visited.    I  952  (2), 

2517.  Restriction  or  deprivation  of  liberty.    I  952  (2)o. 

2518.  Re.striction  of  communication.    I  9-52  (2)6. 

2519.  Restriction  of  supplies.    I  952  (2)c. 

2520.  Modification  of  routine  and  drills.    I  952  (2)d. 

2521.  Control  of  conditions  affecting  health.    I  9.^2  (2)0. 

2522.  Precautions  in  Tropics.    1952  (S). 

2523.  Anchorage  in  Infected  ports.    I  952  (4). 

2524.  Sanitary  instructions  of  department  to  be  observed.    I  952  (5). 
2526.  Precautions  to  be  taken  to  preserve  health  of  troops  embarked.    R  1631. 

Section  3. — ^Navy   Regulations   and   Naval   Instructions   Relating   to  the 
Sanitary  Duties  of  the  Commanding  Officer. 

2631.  He  shall  frequently  consult  with  the  medical  officer  In  regard  to  the 
sanitary  condition  of  the  crew.    R  20  (S). 

2632.  Prison  spaces  to  be  reiwrted  upon.    R  1431. 

2533.  To  use  all  proper  means  to  preserve  health  of  crew.    R  2044. 
.ii  2534.  To  observe  the  instructions  contained  In  I  952    (sanitary  duties  of 
commander  In  chief).    R  2112. 

2535.  Liberty  dependent  upon  local  sanitary  conditions.    R  3670  (2).     - 

2536.  Destruction  of  olotlilng  to  prevent  spread  of  disease.    I  1351 ;  I  4750. 

191 


192        MANUAL   FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

•2537.   Survey  of  insanitary  articles.     I  4735. 

2538.  Fires  in  warm  weather  to  be  extinguished  as  soon  as  practicable,  hav- 
ing in  view  comfort  of  crew.    I  2607  (1). 

2530.  Lights  reduced  unless  required  for  comfort  of  crew.    I  2007  (3). 

2540.  Sufficient  light  to  be  supplied  for  reading.     I  2607  (8). 

2541.  Regular  boat  trips  to  be  made  when  sanitary  conditions  permit. 
I  2608   (1). 

2542.  Ship  to  be  kept  clean,  dry,  at  a  comfortable  temperature,  lighted,  ven- 
tiliited.  etc.     I  2617  (1). 

2543.  Exposure  of  crew  to  sun,  wet,  contagion,  etc.,  to  be  avoided.  Com- 
manding officer  to  consult  medical  officeu  regarding  measures  to  preserve  health 
of  crew;  men  suffering  from  disease  not  to  have  liberty  except  upon  reconi- 
mendatioQ  of  the  medical  officer;  division  officers  to  iuapect  clothing  of  men 
as  to  cleanliness;  clothing  wet  with  perspiration  to  be  washed  and  dried  before 
storing;  bedding  to  be  aired  once  a  week  and  mattresses  picked  over  and  tickings 
washed  once  a  year;  blankets  to  be  washed  as  often  as  necessary.    I  2617  (1-6). 

2544.  Ck)oking  and  mess  utensils  to  be  clean;  food  wholesome  and  well 
cooked,  and  water  approved  by  medical  officer.    I  2618  (5). 

2545.  No  harbor  water  to  be  used  on  decks  where  water-borne  diseases  are 
prevalent,  or  where  contaminnted  by  sewage,  animal  matter  or  refuse.    I  2621. 

2546.  Commanding  officer  to  be  informed  by  executive  officer  relative  to 
physical  capacity  of  crew.    I  1402, 

Section   4. — Navy   Regulations   and  Naval   Instructions   Relating  to  the 
Sanitary  Duties  of  the  Fleet  Surgeon. 

2651.   See  "  Duties  of  the  Fleet  and  Division  Surgeon,"  chapter  7.    1 1122. 

Section   5. — Navy   Regulations  and  Naval  Instructions   Relating   to   the 
Sanitary  Duties  of  the  Medical  Officer  of  a  Ship. 

2561.  To  report  infectious  and  contagious  diseases.     R2952. 

2562.  To  report  on  sanitary  condition  of  the  port.     R  2953. 

2563.  Sanitary  suggestions  and  recommendations  to  the  commanding  officer. 
R  2954. 

2564.  To  report  on  diseases  among  personnel  with  appropriate  recommenda- 
tions.    R  2955. 

2565.  Inspection  of  food  for  sick.     R2959. 

2566.  Sanitary  data  prescribed  in  Manual  to  be  obtained  .in  foreign  porta 
(see  infra  "  Medical  Reports  of  Office  of  Naval  Intelligence  ").    R  2966  (1). 

2567.  To  report  upon  epidemics  of  contagious  tlisease  in  West  Indian  ports, 
etc.     R  2966  (2). 

2568.  To  Inspect  provisions  of  the  crew.     I  2110. 

2569.  To  examine  cooking  and  drinking  water  from  shore.    I  2112. 

2570.  To  inspect  fresh  provisions  (junior  medical  officer).  (I  2618  (2))  ; 
I  2113   (1). 

2571.  Food  and  drink  in  bumboats  (junior  medical  officer).  (I  2514  (6))  ; 
I  2113  (2). 

2572.  The  medical  officer  to  Inspect  cells  and  prisoners.     (R  14.31);  12114. 

2573.  To  accompany  tirst  lieutenant  on  weekly  ia.spection.     1211."). 

2574.  Yearly  sanitary  report  to  department  (Bureau  of  Medicine  and 
Surgery).  (In  duplicate,  one  copy  marked  "For  the  commanilor  in  chief.") 
I  2127.' 

2575.  Hospital  Corps  to  be  instructed  in  personal  and  ^jliip  hygieue.  I 
2042  (1). 

2676.   Vaccination  of  crew  upon  commission  and  thereafter.     12103;  13211. 
2577.  Typhoid  prophylactic  to  be  administered  to  all  iHTSons.     18212. 
2678.  Urgent  repairs  for  sanitary   reasons.     14801(1). 


MANUAL    FOR    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.        193 

2570.  Follow  regulations  and  practice  established  by  "Fleet  Regulations" 
of  the  force  to  which  ship  is  assigned. 

Section   6. — Navy  Regulations   and  Naval   Instructions   Relating  to  the 
Sanitary  Duties  of  Officers  in  Hospitals  (and  Hospital  Ships). 

2681.  Medical  officer  in  command  of  hospital  (and  hospital  ship)  responsi- 
ble for  its  cleanliness.    R  2919  (1). 

2582.  Inspection  of  provisions  at  hospitals  (junior  medical  officer).     13225. 

2583.  Medical  officers  in  charge  of  hospital  wards  held  responsible  for  their 
neatness  and  good  order.     I  3228. 

2584.  Sanitary  report  from  hospitals  to  be  submitted  yearly  to  department 
(Bureau  of  Medicine  and  Surgery).     I  3259. 

2585.  Harbor  regulations  to  be  observed  by  hospital  ships.    I  4015. 

2586.  Master  of  hospital  ship  to  observe  regulations  regarding  cleanliness 
of  ship  and  crew.     14017(7). 

Section   7. — Navy  Regulations   and  Naval  Instructions   Relating   to  the 
Sanitary  Duties  of  a  Medical  Officer  on  a  Shore  Station. 

2591.  To  "supervise  hygiene  of  station  and  recommend  measures  to  diminish 
disease;  to  examine  monthly  and  note  in  journal  the  sanitary  condition  of 
buildings,  etc.,  and  report  thereon.     R  2901  (2). 

2592.  Officers  and  men  at  navy  yards  and  naval  stations  to  notify  medical 
officer  of  existence  of  contagious  diseases  in  their  quarters.     R  4006  (8). 

2503.  Sanitary  report  (yearly)  to  department  (Bureau  of  Medicine  and 
Surgery).    18239. 

2504.  Commanding  officer  of  marines  to  see  that  sanitary  regulations  are 
enforced  in  barracks.     13578. 

2506.  Commanding  officer  of  naval  prison  responsible  for  sanitation  of  the 
prison.     (Art.  9,  Rules  and  Regulations,  Naval  Prisons  and  Prison  Ships.) 

2597.  Report  on  operations  of  the  prison  to  include  a  separate  report  from 
the  medical  officer.     (Arts.  25,  60,  Rules  and  Regulations,  Naval  Prisons,  etc.) 

Section  8. — Sanitary  Directions  for  the  ^Iedical  Officer  of  a  Ship. 

2601.  It  is  the  duty  of  the  medical  officer  to  make  recommendations  to  the 
commanding  officer  relating  to  the  sanitary  and  hygienic  condition  of  the  ship 
and  crew.     (R  20  (8)  ;  R  2954;  R  2955)  ;  I  2617  (2). 

2602.  Strict  attention  should  be  paid  to  ship  ventilation  and  inspections 
made  to  see  that  every  care  is  taken  to  utilize  to  the  best  advantage  the  methods 
provided  for  the  proper  supply  and  renewal  of  the  air.    I  952  (2)d;  I  2617  (1). 

2603.  Only  distilled  water  should  be  used  for  drinking  and  culinary  pur- 
poses. In  ports  where  cholera,  typhoid  fever,  or  dysentery  prevail  either  in  a 
sporadic  or  in  an  epidemic  form  the  use  of  harbor  water  on  any  of  the  decks 
should  not  be  permitted.  This  prohibition  should  also  apply  where  the  harbor 
water  is  contaminated  by  sewage,  animal  matter,  or  refuse.     I  2621. 

2604.  Careful  attention  should  be  given  to  the  food  supply,  and  in  localities 
where  night  soil  is  u.sed  for  fertilizing  purposes  none  of  the  vegetables  ordinarily 
eaten  uncooked  should  be  allowed  on  board.    R  2959  ;  I  2110 ;  I  2113  ;  I  2618  (2). 

2605.  Clothing  adapted  to  the  climate  should  be  worn,  witli  prompt  changes 
to  meet  varying  changes  of  the  weather.  The  wearing  of  white  should  be  con- 
fined to  days  when  the  thermometer  is  not  below  SO  F.  Seventy-five  degrees 
Fahrenheit  at  7  a.  m.  is  suggested  as  the  standard  for  prescribing  clothing  of 
white  as  the  uniform  of  the  day.  Bathing  over  the  ship's  side  should  not  be 
allowed  when  the  water  is  below  70  F.,  nor  when  the  water  is  contaminated 
by  sewage  or  refuse,  nor  until  the  ship's  lieads  have  been  closed  for  an  interval 
prior  to  the  swimming  call.     Midday  bathing  in  the  Tropics  should  not  be  per- 

98601°— 17 13 


194        MA^'UAL   FOR    Tlili    MEDICAL   DEPARTMENT,    U.    S.    NAVY. 

luilled  under  uidiuary  circuuistauces  wheu  iirotectiou  Irom  the  direct  nijs  of 
I  lie  sun  is  impossible.  Clothing  that  has  been  wet  by  perspiration  should  always 
be  dried  before  being  rolled  up  or  stowed  away.     I  li617  (2)  (3). 

2606.  Infected  ports  should  be  avoided  when  practicable.  An  anchorage  in 
malarial  and  in  infected  ports  should,  whenever  practicable,  be  selected  to  wind- 
ward of  and  at  a  suitable  distance  from  the  jn-obable  source  of  infection. 
1952(4). 

2607.  Upon  arrival  in  unhealthy  ports  Information  regarding  the  health  of 
the  neighborhood  shall  be  immediately  obtained,  and  in  the  event  of  the  preva- 
lence of  infectious  diseases  such  precautionary  ineasures  should  be  adopted  as 
are  consistent  with  the  necessities  of  the  ship  and  the  exigencies  of  the  service. 
(R  2953;  I  952  (2).) 

2608.  Should  it  be  found  that  the  port  or  neighborhood  is  unhealthful  on 
account  of  the  prevalence  of  an  infectious  or  contagious  disease,  the  precau- 
tionary measures  indicated  in  articles  I  952  and  I  2617  should  be  reconniiended. 
as  well  :is  others  deemed  advisable. 

2609.  The  crew  should  b«  exposed  as  little  as  possible  to  the  rays  of  the 
sun.  At  anchor  in  the  Tropics  during  the  hot  season,  ship's  boats  when  lowered 
should  keep  their  awnings  spread  between  the  hours  of  S  a.  m.  sind  4  p.  in. 
regardless  of  the  disposition  of  the  ship's  awnings.  Ship's  awnings  should  be 
spread  as  much  as  practicable  for  protection  from  sun  in  the  day  and  from  dew 
an<l  rain  at  night.  The  provisions  regarding  awnings  should  not  apply  in  cloudy 
weather  nor  wheu  high  winds  prevail. 

2610.  After  sunset  the  crew  may  be  required  tp  dress  in  blue,  and  if  they 
sleep  on  deck  they  should  remain  under  cover  and  be  protected  from  falling  dew 
and  inclement  weather.  When  unavoidably  exposed  to  rain,  prompt  shifting 
into  dry  clothina;  should  be  enforced  and  the  body  should  Ix'  vigorously  rubbed 
with  a  rough  towel. 

2611.  In  getting  under  way  from  polluted  harbors  the  mud  on  the,  anchor. s 
and  chains  should  be  carefully  removed. 

2612.  Every  per.son  in  the  naval  service  should  be  afforded  such  protecUon 
from  smallpox  as  is  secured  by  vaccination.  Each  person  not  successfully  vac- 
cinated during  his  enlistment  should  be  revaccinated  as  soon  as  practicable,  and 
it  should  be  repeated  until  the  medical  ofTlcer  is  satislied  that  he  is  i)roterted. 
The  medical  officer  should  satisfy  himseif  that  all  the  i)ersonnel  is  i)rotected 
against  typhoid  fever  and  has  had  the  prescribed  antityphoid  prophylactic 
injections.  Wlien  frequent  transfers  render  difficult  the  administration  of  anti- 
typhoid inoculations  at  10-day  Intervals  this  period  may.  in  the  discretion  <>f 
the  medical  oflScer,  be  reduced  to  7  days,  unless  violent  reaction  follows  first 
injection. 

A  speciii)  report  should  be  made  of  illness  considered  to  l)e  typhoid,  stating 
whether  the  diagnosis  is  confirmed  by  laboratory  flnding.s.  the  number  and 
dates  of  antityphoid  inoculation,  and  if  not  administered  the  reasons  for  its 
omission.     (M.  &  S.  No.  124527.) 

2613.  -Vll  ships  cruising  In  the  Tropics,  and  particularly  in  latitudes  where 
yellow  fever  and  malaria  usually  prevail,  should  be  provided  with  an  ample 
snpply  of  mosquito  nets,  and  under  no  circumstances  sliouUl  camping  pnrties  bo 
sent  from  the  ship  without  being  furnished  with  such  protection. 

2614.  Whenever  a  contngious  or  infectious  disease  appears  on  Ijoard  ship 
every  precautionary  measure  consistent  with  the  exigencies  of  the  service  should 
be  adopted  to  prevent  its  spread.  Official  reports  shonl«l  lie  made  to  c-oni- 
mnnding  officer  and  through  him  to  conunander  in  chief. 

2615.  Whenever  cholera,  yellow  fever,  smallpox,  or  other  infectious  or. con- 
tagious disease  appears  on  l>oar<1  ship  tlio  following  measures  should  he  c'arr 
ried  out :  ,' 

(«)  The  prompt  removal  of  the  iiatient  or  patients  to  .-i  hospital  wheneveV 
such  removal  Is  possible.  ', 

(ft)  The  isolation  of  those  aflfectied.  and  the  segregation  under  observation  91 
the  exiMised.    The  establishment  of  n  cam|i  oi\  shore  may  he  advisable,  to  com- 


MAisUAL    FOR    THE    MKDKJAL    tVEPARJ'MEiN'JV,    U.    S.    NAVY.        195 

priise  u  reoeplioii  unit,  u  camp  of  observutiou  (incubation),  a  cauip  of  suspects, 
hospital,  and  clean  camp.     (See  Sanitary  Directions  for  Lamliug  Parties.) 

(c)  The  prompt  disinfection  and  fumigation  of  the  apartments  occupied  by 
the  patient ;  also  the  disinfection  of  the  bedding,  clothing,  and  any  other 
articles  that  may  be  deemed  necessjiry  or  desirable,  and  the  investigation  and 
removal  of  any  local  cause. 

(fZ)  When  the  disease  is  cholei-a  or  yellow  fever,  the  ship,  if  in  an  un- 
healthy port,  should  leave  as  soon  as  practicable  and  measures  should  be  in- 
stituted for  the  thorough  disinfection  of  the  ship.     (See  ch.  15,  par.  2782.) 

(e)  When  malaria,  dengue,  or  yellow  fever  appears  on  board  shij)  the  patient 
or  patients  shall  be  thoroughly  screened  with  mosquito  netting,  and  measures 
taken  at  once  for  the  extermination  of  all  mosquitoes  on  board  and  for  prevent- 
ing their  reimportation.  In  localities  where  mosquitoes  and  flies  are  prevalouf. 
the  thorough  screening  of  all  patients  with  active  specific  diseases  and  typhoid 
fever  is  advisable.  The  disinfection  of  the  clothing  and  bedding  of  yellow- 
fever  patients  and  of  their  apartments  is  not  deemed  necessary  except  for  the 
purpose  of  destroying  mosquitoes. 

(/)  .ill  patients  with  pulmonary  tuberculosis  and  those  su.spected  of  being 
tuberculous  shall  be  carefully  instructed  how  to  dispose  of  sputum  without 
danger  to  others.  Such  cases,  until  transferred  to  hospital,  should  also  be  re- 
quired to  mess  apart  from  others  and  to  use  separate  mess  gear,  which  shall 
be  sterilized  by  boiling  after  use. 

2616.  Whenever  in  the  opinion  of  the  medical  officer  it  becomes  necessary  to 
disinfect  the  ship  the  appropriate  measures  noted  under  "  Disinfectants,'"  chap- 
ter 15.  section  5,  should  be  carried  out.     (See  also  par.  2782.) 

2617.  As  a  means  of  preventing  the  spread  of  disease  on  board  ships  not 
provided  with  the  sanitary  scuttle  butt  terminals,  the  scuttle  butt  cup  should 
be  kept  submerged  in  a  solution  of  formaldehyde  (1-2500).  A  metallic  bucket, 
painted  white,  with  a  Geneva  cross,  may  be  attached  to  the  scuttle  butt  for  this 
purpose.  The  medical  officer  should  see  that  the  bucket  is  kept  properly  sup- 
plied with  the  proper  solution,  and  require  that  some  person  be  responsible  foi- 
its  cleanliness. 

On  board  ships  provided  with  the  sanitary  scuttle  butt  terminals  efficient 
and  frequent  measures  should  be  taken  to  insure  an  absence  of  infection  in  the 
terminals  themselves,  such  as  a  daily  flaming  with  blowtorch,  etc. 

2618.  When  men  are  required  to  work  in  compartments  containing  lead- 
laden  dust  from  chipping  red  lead  some  type  of  respiratory  mask  should  be 
provided  to  minimize  the  danger  of  lead  poisoning,  and  thorough  washing  of 
the  hands  before  eating  insisted  upon.  The  chewing  of  tobacco  while  working 
with  lead  or  lead  compounds  should  be  prohibited.  <M.  &  S.  Circular  Letter 
124713.) 

Section  9. — Sanitary  Directions  fok  Landing  Pasties  in  Camp. 

(See  also  Notes  on  Military  Hygiene;  Landing  Force,  and  Small  Arms  In- 
structions, 1912,  and  Expeditionary  Service,  chap.  10,  sees.  3-5.) 

2621.  Medical  officers  accompanying  landing  parties  shall,  in  general,  be 
guided  by  the  following  rules: 

(a)  Camping  sites:  Camping  sites  will  be  selected  by  the  officer  in  command 
of  the  encampment  upon  the  recommendation  of  the  senior  medical  officer. 
Camps  should  be  pitched  on  dry,  elevated  land,  with  natural  drainage,  remote 
fi-om  and  to  windward  of  marshes  and,  if  possible,  with  hills  and  trees  inter- 
vening. Tents  should  have  their  openings  facing  away  from  all  marshy  soil 
and  the  cots  of  all  officers  and  men  should  be  provided  with  mosquito  nets,  to 
be  used  as  a  protection  against  the  spread  of  disease  by  means  of  these  insects. 

(&)  No  site  should  be  used  as  a  camp  or  halting  station  that  has  been  pre- 
viously employed  for  similar  purposes  if  it  can  be  avoided.  Except  in  cases  of 
urgent  necessity  neither  the  temporary  nor  permanent  occupation  of  buildings 
should  be  allowed  for  quartering  men.     The  camp  should  bo  so  placeil  that  the 


196        MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

prevailing  wind  will  blow  toward  possible  breeding  places  for  mosquitoes  and 
will  not  Mow  dust  and  flies  from  the  latrines  toward  the  kitchens. 

(r)  Water  siipjily  :  No  wiiter  other  than  distilled  water,  except  boiled  water, 
shall  be  nsed  for  drinking  or  cooking  purposes  if  practicable.  When  water  can 
not  be  boilefl  a  sedimentation  and  filtration  process  is  desirable.  Use  barrels  or 
boxes  with  sand,  pebbles,  and  charcoal  for  this  purpose.  Disinfect  sand  and 
pebbles  by  prolonged  heating  before  constructing  filter.  Cooking  utensils  and 
dishes  used  to  contain  food  should  be  washed  in  water  that  has  been  boile<l. 
Water  collected  from  streams  and  wells  is  always  suspicions  and  should  be  boileii 
before  using,  thus  preventing  the  appearance  of  typhoid  fever,  cholera,  and 
dysentery.  On  going  into  camp  the  w;!ter  supply  should  be  immediately  placed 
under  intelligent  .supervision,  and  its  approach  protected  by  boanis,  rails,  or 
logs,  even  in  temporary  camps. 

Kxperiments  have  shown  that  one  gram  of  hypochlorite  of  calcium  (30  per 
cent  chlorine)  in  40  gallons  of  water  (l/HOO.OOO)  will  destroy  all  pathogenic 
organisms  in  10  to  30  minutes,  even  though  the  water  be  heavily  infected.  This 
is  the  simplest  and  most  practical  method  for  purifying  drinking  water  in  the 
field  and  on  the  march. 

(tl)  Suitable  clothing  should  be  provided  to  meet  probable  vicissitudes  of  the 
weather.  The  men  sliould  be  sheltered  from  rain  and  night  dews  and  from  the 
direct  rays  of  the  sun.  Under  no  circumstances  should  the  men  be  allowed  to 
sleep  in  wet  clothing. 

(e)  The  men  should  nnt  be  permitted  to  sleep  on  the  ground  nor  without 
cover,  nor  should  they  be  permitted  to  go  about  in  their  bare  feet.  When  ex- 
posed to  a  hot  sun  the  men  should  wear  fresh  green  leaves  or  handkerchiefs, 
moistened  with  water,  inside  of  their  hats  or  caps.  During  the  heat  of  the 
day  only  ai)solutely  necessary  work  should  be  done. 

(/)  Food  :  T!ie  food  should  be  inspected  before  and  after  cooking,  and  the 
men  should  breakfast  previous  to  any  exposure  and  as  soon  as  practicable  after 
turning  out.  Fruits  which  are  ripe  and  sound  and  which  are  skiiuied  or  cooked 
before  eating  are  not  objectionable.  Lime  and  lemon  .juice  if  availalilo  can  be 
used  freely.  The  use  of  any  article  of  diet  not  embraced  in  the  Navy  ration 
should  be  allowed  only  upon  the  recommendation  of  the  medical  ofhcer.  Meals 
should  be  served  warm  and  at  regular  hours  and  carefully  protected  from  flies. 
The  guard  at  night  should  have  coffee  and  biscuit  before  going  on  duty,  and 
this  should  also  apply  to  relief  parties. 

iff)  All  officers  and  men  should  be  cautioned  against  excessive  fatigue,  over- 
crowding, and  exposure  to  hximidity  and  to  abrupt  changes  of  temperature. 

(h)  Latrines:  Latrines  should  be  placed  to  leeward  and  below  the  camp  and 
as  far  as  practicable  away  from  the  wiUer  suy)ply  and  kitchens.  V)ry  earth, 
sand,  or  lime  should  be  scattered  over  the  contents  of  the  pits  every  morning  and 
evening,  or  tJiese  may  be  covered  with  kerosene,  which  may  be  .set  afire,  or  with 
crude  carbolic  acid  and  water. 

(i)  Camp  refuse:  All  refuse  from  the  camp  should  be  buried  in  pits  or  burned 
in  an  Incinerator.  All  choleraic,  enteric,  and  dysenteric  discharges  should  be 
burned  or  buried  after  disinfection.  The  grounds  and  tent.s  should  be  kept 
thoroughly  clean,  and  should  be  inspected  daily,  or  oftener,  if  necessary,  by  the 
medical  ofiicci-  and  by  jiolicing  oflicer  and  his  jiarty. 

{})  Quarantine:  In  the  event  of  any  contagious  or  infectious  disease  making 
its  ajtpearance  in  the  neighborhood  of  the  eniampment,  the  camp  should  be 
placed  in  a  state  of  quarantine  against  the  natives  and  all  other  i)ersons  condng 
in  from  the  inlected  locality,  and  Intercourse  should  be  permitted  only  under 
special  regulations. 

(k)  Tho  senior  medical  officer  of  the  encampment  should  cause  to  be  made 
thorough  iii.«iu'ction  daily  of  all  parts  of  the  caiiiji,  and  slionid  report  all  viola- 
tions (»r  noncompliance  witli  the  sanitary  instructions  of  the  officer  in  cnnnnand. 

(?)  Should  contagious  diseasr  appear  aincnig  the  men  ii\  caiup,  it  may  be 
advisable  to  establish  a  coi\tagious-disease  can\p.  which  slioidd  be  locati'd  with 
reference  to  proper  isolation  of  the  side,  accessibility,  and  the  necessary  facili- 


MANUAL    FOE   THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY.         197 

ties.  It  may  be  arranged  with  a  reception  unit  for  inspection  and  disinfection, 
tliose  passing  inspection  to  go  to  a  clean  camp  or  to  a  camp  of  observation 
Tliose  not  passing  inspection  should  be  sent  either  direct  to  a  hospital  (disease 
present)  or  to  a  camp  of  suspects.  Cases  remaining  under  observation,  if  pass- 
ing the  period  of  incubation  for  the  disease  in  question,  may  be  returned  to  the 
clean  camp.  If  suspicious  cases  appear  among  those  under  observation  or  in 
the  clean  camp,  they  are  passed  to  the  camp  of  suspects  or  to  hospital. 

(m)  The  accumulation  of  vegetable  refuse,  garbage,  waste  paper,  old  rags, 
manure  or  fecal  matter  unprotected  from  Hies  should  be  prohibited,  as  these 
form  favorable  breeding  grounds  for  insects.  If  practicable,  thorough  screening 
of  all  places  in  which  food  is  prepared  or  served  shall  be  done  as  soon  as 
possible.     (M.  &  S.  124733.) 

Section  10. — Navy  Regulations  and  Naval  Instructions  Relating  to  Sani- 
tary Reports. 

2631.  Monthly  reports  on  shore  stations.     R2901  (2). 

2632.  Medical  officer  of  ship  to  report  immediately  any  infectious  or  con- 
tagious disea.se  (R  2952)  (I  916  (3)e)  ;  to  report  health  of  the  port  (R  2953)  ; 
to  report  presence  of  disease  among  personnel  (R  2955)  ;  to  obtam  sanitary  data 
for  bureau  (Intelligence  reports),  (I  2511)  (R  2966  (1)  ;  to  report  prevalence 
of  diseases  in  West  Indies,  etc.  (R  2966  (2)  ;  to  report  sanitary  deficiencies  of 
ships  (I  2101)  ;  to  make  sanitary  report  on  .Tanuary  1  to  department  (Bureau 
of  Medicine  and  Surgery)  in  duplicate  (I  2127).     See  also  2579. 

2633.  Fleet  surgeon  to  prepare  and  forward  general  sanitary  report  at  end 
of  year.    I  1122  (8). 

2634.  Medical  officer  of  shore  station  to  submit  on  January  1  a  sanitary 
report  to  department  (Bureau  of  Medicine  and  Surgery).    I  32.59. 

2635.  Medical  officer  in  command  of  hospital  to  submit  a  sanitary  report  on 
.January  1  to  department  (Bureau  of  Medicine  and  Surgery).    I  3259. 

Section  11. — General  Instructions  Relating  to  Sanitary  Reports. 

2641.  All  medical  officers  in  charge  of  medical  departments  ashore  and  afloat, 
including  hospitals,  navy  yards,  naval  stations,  and  marine  barracks,  and 
marine  detachments,  are  required  by  regulations  (I  2127,  I  3259)  to  prepare  and 
forward  through  official  channels  to  the  department  (Bureau  of  Medicine  and 
Surgery),  on  January  1,  reports  relating  to  all  matters  of  sanitary  and  pro- 
fessional interest  coming  under  their  observation  during  the  previous  year. 
These  reports  should  be  in  triplicate,  one  being  retained  in  the  files  of  the 
Medical  Department,  and  one,  in  the  case  of  ships,  being  marked  "  For  the 
commander  in  chief." 

2642.  For  the  compilation  of  sanitary  reports,  notes,  data,  and  memoranda 
of  value  in  the  preparation  of  the  yearly  sanitary  report  shall  be  made  and 
placed  in  the  files  in  order  to  be  available  on  January  1  by  the  medical  officer 
then  in  charge.  Senior  medical  officers  when  detached  shall  be  careful  to  see 
that  such  data  are  available  for  the  use  of  their  successors. 

Section  12. — Preparation  of  Sanitary  Reports. 

In  the  preparation  of  sanitary  reports  the  following  outlines  of  the  main  sub- 
jects to  be  treated  will  be  used  for  the  guidance  of  medical  officers. 

2(J51.  Hospitals:  (a)  Condition  of  hospital  building,  including  administra- 
tive building,  offices,  wards,  and  building  for  the  treatment  of  infectious  dis- 
eases; the  topography  of  the  hospital  grounds,  with  suggestions  and  recom- 
mendations for  sanitary  improvement;  the  water  supply,  whether  satisfactory 
for  all  purposes;  provisions  in  case  of  fire,  the  drainage  and  .sewerage  systems 
employed,  and  methods  for  the  disposal  of  garbage  and  excreta  :  the  heating, 


J98         MAKIAI.    lOl;    THK    MKUKAI.    UKl'Ai; TMI^NT,    U.    8.    NAVY. 

veatihiting.  aud  lighting  facilities:;  the  general  siinitary  uinmgeiiient  and  con- 
dition of  all  buildings  included  in  the  hospital  grounds,  and  any  recommenda- 
tions that  may  l>e  deemed  advisable  for  impro\einent :  the  oi>erating  room, 
whether  constructed  to  meet  modern  surgical  rcquinMiionts;  its  equipment  and 
fittings;  the  cniaiition  of  the  floors  and  walls  of  all  hospUal  rooms  and  wards, 
and  if  supi>lied  with  sanitary  furniture;  the  dietetic  appointments  of  the 
hospital,  the  quality  of  the  food  supply,  the  fuel  sujjply,  laundry  and  sterilizing 
apparatus;  methods  for  the  transi)ortati(m  t»f  the  sick  and  injured,  the  kinds 
of  stretchers  used,  ambulance  service,  and  the  regulations  adopted  by  the 
hospital  for  such  service;  the  per.soniiel  of  the  hospital,  including  the  Hospital 
Corps,  nur.ses,  watchmen,  firemen,  cooks,  laundresses,  attendants,  etc.  All 
recommendations  relating  to  increased  efficiency  in  the  duties  of  the  Hospital 
Corps  and  Nurse  Corps;  reports  upon  all  oi>erations  performed  during  xW: 
calendar  year,  and  a  general  summary  dealing  with  the  treatment  of  disease; 
facilities  afforded  by  the  hospitid  for  the  treatment  of  all  cases  of  contagious 
disease;  facilities  afforded  by  the  hospital  for  bacteriological  and  cheudcal 
work;  and  facilities  for  the  disposal  of  the  dead. 

(b)  Recommendations  regarding  new  construction  or  repairs  and  improve- 
ments to  buildings  and  grounds  should  be  forwarded  as  an  appendix  to  the 
sanitary  report,  entitled  "  Public  works."  Items  should  be  arranged  in  the 
order  of  their  relative  importance  and  performance  during  the  current  calendar 
.rear  and  under  the  two  headings  "  Necessary "'  and  "  Desirable."  with  an  ap- 
proximate estimate  of  the  cost  of  each  item  of  work. 

It  should  be  borne  in  mind  that  work  which  of  itself  may  be  of  the  greatcsf 
ultimate  importance  might  be  of  minor  importance  for  immediate  performance 
and  items  unauthorized  one  year  may  o(;(Upy  an  entirely  different  relative  posi- 
tion in  work  recommended  in  a  subsequent  year. 

In  order  that  these  reconmiendations  may  be  before  the  bureau  at  the  earliest 
firacticable  date  this  appendix  should  be  submitted  separately,  if  for  an\ 
reason  the  complete  sanitary  report  shoidd  be  unavoidably  delayed. 

2652.  The  yearly  sanitary  report  from  navy  yards  and  naval  stations  sliall 
include  a  general  description  of  the  grounds  :ind  buildings,  with  such  sanitary 
suggestions  and  recommendations  as  may  be  deemed  necessary.  Monthlj'  sani- 
tary rer>orts  from  navy  yards  and  naval  stations  (including  receiving  ships)  for 
the  information  of  the  Bureau  of  Medicine  aud  Surgery  shall  be  forwarded 
through  the  commandant  in  accordance  with  the  provisions  of  article  R  2901  (2). 
Ships  in  reserve  at  a  navy  yard,  in  connnission,  to  which  a  medical  officer  is 
attached  or  assigned  to  duty,  will  not  be  include<l  in  the  monthly  .«!anltary 
report  made  by  the  senior  u)edical  oflicer  of  a  naval  station. 

2653.  Ships  :  Foini  for  sanitary  repf>rts.    The  title-page  shall  read  as  follows  : 

Sanitary  Report 
of  the 

IT.   S.  S. 

for  the  year  19 — . 

The  second  page  shall  contain  a  tal)le  of  contents  with  Index  of  pages. 

Sanitary  reports  from  ships,  while  embracing  matters  of  general  sanitation 
and  professional  intoresl,  shall  give  special  attention  to  Information  and  recom- 
mendations tending  to  promote  military  efficiency  through  the  maintenance  of 
physical  Otness  in  the  personnel.     (12127.) 

The  personnel. — Complement  of  ollicers  and  men ;  percentage  of  sickness  and 
mortality;  general  health;  epidemics;  venereal  disease;  vaccinations. 

Structural  details  of  ship  in  their  sanitary  aspeets. — Number  of  decks^  and 
number  of  men  berthed  on  each  deck;  cubic  air  space  allowed  each  man  ;  venti- 
lation, amount,  means,  defects,  and  remedies;  lighting,  amount,  means,  defects, 
and  remedies;  heating,  amount,  moans,  defects,  and  remedies;  water,  source, 
composition,  supply,  aud  preservatioji :  snnltar.v  fittings,  water-olo.set8,  and 
urinals;  bathing  facilities. 


MANUAL   FOR    THE   MEDICAL  DEPABTMENT,    TJ.    S.    NAVY.        199 

l^avy  ration. — Quality,  preparation,  and  composition ;  tlie  general  massing 
system;  ship's  stores ;  ice  machine  and  refrigerating  rooms ;  location  of  the 
ship's  galley. 

Clothing. — Adaptability  for  different  climates,  its  texture  and  durability; 
ship's  laundry,  capacity  and  efBciency.  'vi 

Cells  lor  prisoners. — Number  and  location ;  cubic  capacity,  ventilation,  heat- 
ing, lighting,  and  sanitary  policing  of  each  cell.     (R  1430:  R  1431.) 

Medical  and  surgical  stippUes. — Quality  and  quantity. 

Facilities  for  the  treatment  of  the  sick. — Sick  bay;  location,  capacity,  number 
of  berths,  equipment  and  fittings,  ventilation,  lighting,  and  heating ;  dispensary, 
location,  cubic  capacity,  equipment  and  fittings,  ventilation,  heating,  and  light- 
ing: medical  storeroom,  location,  capacity,  ventilation,  lighting,  and  arrange- 
ments for  storing  surgical  and  medical  supplies.  Similar  information  will  be 
furni.shed  regarding  operating  rooms,  isolation  wards,  and  venereal  treatment 
and  prophylaxis  rooms,  if  the  ship  is  provided  with  them. 

Stations  in  battle. — Battle  dressing  stations ;  arrangements  for  the  care  and 
tran.sportation  of  the  wounded. 

Hospital  Corps. — Hospital  Corps  drill ;  instructions  in  first  aid  ;  transportation 
of  the  wounded ;  apparatus  employed  in  handling  the  wounded. 

General  hygienic  considerations,  suggestions,  and  recommendations. 

2651.  Whenever  the  opportunity  presents  itself  medical  ofiicers  shall.  If 
practicable,  submit  to  the  Bureau  of  Medicine  and  Surgery  all  information  of  a 
sanitary  and  professional  interest  pertaining  to  foreign  naval  medical  estab- 
lishments. 

2655.  When  cruising  on  foreign  stations  or  in  watei's  beyond  the  continental 
limits  of  the  United  States,  medical  ofiicers  desiring  to  i-eport  in  full  upon  the 
sanitary  condition  of  the  various  ports  visited  by  the  ship  will  use  the  following 
outline:  - 

(a)  Location,  populatiou,  and  climate:  (a)  Latitude  and  longitude,  general 
altitude  above  the  sea  level;  (b)  meteorological  observations,  including  direc- 
tion, velocity  of  the  prevailing  winds,  records  of  the  relative  and  absolute 
humidity,  barometric  conditions,  and  temperature  records  for  specified  periods 
of  time;  (c)  drawing  or  tracing,  if  practicable,  of  the  port  or  the  city. 

(b)  Medical  topography:  (a)  Character  of  surrounding  country,  undulating, 
hilly,  mountainous,  or  low  and  marshy ;  (b)  direction  and  distance  of  the  near- 
est hills  or  mountains;  (c)  influences  of  the  topographical  features  in  the 
immediate  vicinity  upon  the  health  conditions  of  the  port;  (d)  area  of  the  city 
or  port  on  mainland:  (e)  streams  of  water  or  canals  passing  through  the  city, 
or  port,  current,  whether  rapid,  moderate,  slow,  or  sluggish;  (f)  portions  of  the 
city  or  port  subject  to  overflow ;  if  so,  its  bearing  on  the  health  of  the  port ; 
(g)  diseases  attributable  to  the  conditions  of  the  soil  or  geographical  formation. 

(c)  Water  supply:  (a)  Source  of  water  supply,  stating  whether  there  are 
any  towns,  villages,  factories,  or  other  sources  of  contamination  located  upon 
the  river  or  stream  above  the  point  at  which  the  water  is  collected ;  (b)  distance 
from  which  the  water  is  brought,  in  what  form  of  conduit,  capacity  of  pipe,  and 
number  of  reservoirs;  (c)  the  processes,  if  any,  that  are  used  for  filtering  or 
purifying,  other  than  by  settling  in  the  reservoirs;  (d)  the  average  daily  amount 
of  water  flowing  into  the  reservoirs  and  the  storage  capacity  of  each  reservoir ; 
(e)  the  average  daily  amount  for  each  inhabitant,  and  the  amount  of  water 
stored  in  the  reservoirs  available  in  case  of  fire;  (f)  the  quality  of  the  water. 
Including  its  physical,  chemical,  and  bacteriological  examination,  the  facilities 
possessed  by  the  city  or  port  for  conducting  such  examination;  (g)  the  u.se  of 
cistern,  well,  or  spring  water ;.  diseases,  if  any,  attributable  to  such  use. 

(d)  Drainage  and  sewerage:  (a)  The  system  of  .sewerage;  (b)  how  con- 
structed, methods  adopted  for  keeping  it  free  from  obstruction;  (c)  proportion 
of  the  area  of  the  city  or  port  not  sewei-ed ;  (d)  does  the  surface  drainage  pass 
into  thesewers,  and  if  so,  is  their  capacity  sufficient  in  heavy  storms;  (e)  dis- 
position of  the  sewage,  how  collected,  how  utilized;  (f)  the  .system  or  method 
by  whicli  the  sewers  are  ventilated;  (g)  the  methods  of  lighting  the  city  or 
port,  whether  by  gas  or  electricity.  ■     '•  .>:     i  ,        i 


200        MANUAL   FOE   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

(e)  Hospitals :  (a)  The  number  of  hospitals  iu  the  city  or  port,  furnishing,  if 
practicable,  a  tracing  or  drawing  of  each  of  them;  (b)  the  location  of  each 
hospital,  nature  of  soil,  direction  and  character  of  drainage,  shape  and  area  of 
grounds,  number  of  rooms  and  beds  for  pay  patients,  number  of  wards  and  beds 
for  charity  patients,  number  of  stories,  number  and  size  of  wards,  floors  and 
cubic  space  for  each  bed,  accessibility  for  landing  patients  transferred  from 
ships,  regulations  relating  to  admission  of  patients  from  men-of-war;  (c)  the 
heating,  ventilating,  lighting  and  sanitary  arrangements,  protection  in  case  of 
fire,  and  whether  the  building  is  fireproof,  operating  rooms,  X-ray  and  labora- 
tory facilities,  contagious  wards,  screening;  (d)  the  date,  if  practicable,  when 
the  hospital  was  erected,  and  whether  constructed  on  the  pavilion  plan;  (e) 
the  operating  room,  paying  special  attention  to  its  equipment  and  fittings;  (f) 
quality  and  quantity  of  food  supply ;  (g)  transportation  of  the  sick  and  injured, 
kinds  of  stretchers  used,  whether  the  hospital  is  provided  with  elevators  and 
ambulances,  and  the  regulations  relating  to  ambulance  service;  (h)  manage- 
ment of  the  hospital,  whether  by  trustees,  municipal  boards,  religitius  orders,  or 
under  the  control  of  medical  men,  method  of  appointment  of  the  medical  and 
surgical  staff,  and  the  manner  of  appointment  and  the  number  of  hospital 
internes;  (k)  the  nursing  staff  of  the  hospital,  the  number  employed,  and  the 
rules  relating  to  their  duty;  (1)  all  practicable  data  bearing  upon  the  regula- 
tions pertaining  to  hospital  management,  and  information  dealing  with  the 
treatment  of  disease. 

(/)   Information  relating  to  health  laws  and  regulations. 

(g)  Quarantine:  Information  relating  to  national.  State,  or  municipal  laws 
or  regulations,  furnishing  copies,  if  practicable,  of  all  such  laws,  ordinances, 
and  regulations.     (See  2579.) 

Section  13. — Sanitary  Data  Rkqitikeu  in  Intelligence  Report. 

2661.  Form    N.  N.  I.  77. 

INTELLIGENCE  RErORT. 

[Forward  direct  to  the  Office  of  Naval  Intelligence.] 


U.  S.  S- 
Name  of  city  or  town: 


Date 


mi<:dioal  rki'okt. 

fThls  report  should  be  made  by  a  medical  officer.] 

Population  of  city  or  town. 

Health  Conditions. 

Epidemic  diseases : 
Endemic  diseases: 

Venereal  diseases,  and  also  any  available   information  conrprning  prevalence 
and  status  of  prostitution  : 

Mi;i)i(  AL  TorooKAPiiY. 
[With  reference  to  Infliionoe  upon  hcfiMh  condttions.] 

Temperature,  average  day, ;  niglit, ;  yearly  maxiniuni. ;  yearly 

minimum, 

Prevailing  winds: 

Prevalence  of  mosquitoes,  flies,  otc. : 


MANUAL   FOR   THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.        201 

Rainfall : 

Drainage : 

Sewerage : 

Height  above  sea  level: 

Camping  sites : 

Water  supply — 

Quantity : 

Quality : 

Method  of  collection: 

Method  of  puritication : 
Food:  Character  and  sanitary  condition  of  hotels  and  restaurants,  etc.: 
Availability  of  surgical  and  medical  supplies : 
Structures  suitable  as  emergency  hospitals: 
Quarantine  regulations: 
Local  laws  or  regulations  regarding  disinterment  should  it  be  desired  to  send 

remains  home: 
Facilities  for  cremation: 

2662.  There  is  published  by  the  Bureau  of  Medicine  and  Surgery  a  Naval 
Medical  Bulletin  for  the  information  of  the  medical  officers  of  the  service. 
Reports  of  interesting  cases,  sanitary  measures  advocated,  new  devices  sug- 
gested, etc.,  original  articles  on  topics  of  general  and  special  professional  in- 
terest are  solicited  from  all  medical  officers.  Contributions  should  be  on  one 
side  of  the  page,  typewritten  if  possible,  double  spaced,  and  carefully  punctuated 
and  paragraphed  to  reduce  the  necessity  for  emendation  by  the  editor.  Special 
accuracy  as  to  names,  editions,  etc.,  should  be  observed  in  all  references  and 
quotations  from  other  periodicals.  It  is  assumed  that  original  articles  con- 
tributed for  the  Bulletin  have  not  appeared  and  are  not  to  appear  in  other 
publications  except  by  previous  agreement  with  the  editor. 


T^T     in- 


CHAPTER  15. 

BII.LS    OF    HEALTH,    QUARANTINE,    AND    DISINFECTION. 
Section  1. — Laws  Relating  to  Quarantine  and  Bills  of  Health. 

2701.  The  public  health.     Sees.  4263.  4792-4800,  R.  S. 

2702.  Vessels  from  foreign  ports  not  to  enter  in  violation  of  this  act  or 
State  health  laws.    Act.  Feb.  15,  1893. 

2703.  Permanent   appropriation  for  prevenriuir  epidemics,   to  be  expended 
in  di.^cretion  of  President.    Act  Mar.  3,  1893. 

2704.  Bills  of  liealth  to  be  obtained  from  consul.     Acts  Feb.  15,  1893;  Aug. 
18,  1894. 

2705.  Quarantine  service,  punishment,  etc.,  upon  quarantine  grounds.     Act 
Aug.  1,  1888. 

2706.  Contagious  diseases,   to  pi-event   the   spread   of.   from   one   State  to' 
:mother.  etc.    Act  Mar.  27,  1890.  ■' 

2707.  Additional   quarantine  powers   and   additional   duties   of  the   Public' 
Health  Service.    Act  Mar.  2,  1901,  amending  act  Feb.  15,  1893. 

2708.  To  further  protect  the  public  health.    Act  June  19,  1906. 

Section  2. — Navt  Regxtlations  and  Naval  Instructions  Relating  to  Quaran-^ 
tine  and  Bills  of  Health.  / 

2711.  Commanding  officers  required  to  comply  strictly  with  all  quarantine 
regulations.    R  3SU1  (1). 

2712.  To  afford  every  facility  to  health  officers.    R  3801  (2).  ■; 

2713.  No  communication  lo  l)e  held  witli  shore  until  pratique  is  gi'anted. 
R.  3801   (3). 

2714.  Procedure    upon    arrival    in    a    port    with    a    quarantinable   disease. 
R  3802  (1).  .X 

2715.  To  arrange  for  care  of  patients  ou  shore  or  on  board  a  hulk.     R  3802  (2);.i 

2716.  When  at  sea  with  quarantinable  disease  to  hoist  and  keep  flying  the 
quarantine  flag.    R  3802  (3). 

2717.  Arriving  vessels  not  to  be  boarded  if  suspected  subject  to  quarantine. 
R  3803   (1). 

2718.  Communication  with  vessels  at  sea,  if  from  a  suspected  port,  to  be 
rejiorted  to  health  officer  upon  arrival  in  port.    R  3803  (2). 

2719.  Circumstances  that  may  subject  a  vessel  to  quarantine  not  to  be  con- 
cealed.    R  3803  (3). 

2720.  Before  proceeding  to  sea  commanding  officer  shall  require  the  medical 
officer  to  procure  bill  of  health  when  necessary  or  advisable.    I  1312. 

2721.  Unless  otherwi.se  directed,  the  medical  officer  shall  procure  a  bill  of 
health.    I  2126  (1).  ,    .     ,     ;      .-      .       .> 

2722.  Upon  arrival   in  port  medical  officer'  to  receive  health  officer^,  etc^i 
I  2126  (2). 

203 


204        MANUAL   FOR   THE    MEDICAL  DEPARTMENT     U.    S.    NAVY. 

Section  3. — Genekai>  Infoumation  Relating  to  Quarantine  and  Qvakantine 

Regulations. 

2731.  The  Public  Health  Service  recognizes  as  quarantinable  the  following 
diseases : 

(a)  Cholera,  period  of  incubation,  5  days. 

(b)  Yellow  fever,  period  of  incubation,  a  or  6  days. 

(c)  Smallpox,  period  of  incubation,  14  days. 

(rf)   Typhus  fever,  period  of  incubation,  12  days. 
(e)   Plague,  period  of  incubation,  7  days. 

(/)  Leprosy:  If  an  alien,  not  permitted  to  land.  If  a  citizen,  the  case  Is 
dealt  with  according  to  the  State  laws  of  the  port  of  entry. 

2732.  146.  Vessels  of  the  Navy  may  be  granted  the  hereinafter-stated  ex- 
emptions from  quarantine  regulations,  but  are  subject  to  quarantine  inspection 
upon  arrival  at  a  port  of  the  United  States. 

147.  The  ceriiticates  of  the  medical  officers  of  the  Navy  as  to  the  sanitary 
history  and  condition  of  a  vessel  and  its  personnel  may  be  accepted  for  naval 
vessels  by  the  quarantine  officer  boarding  the  vessel  in  lieu  of  an  actual  inspec- 
tion. 

14S.  Vessels  of  the  Navy  having  entered  the  harbors  of  infected  ports,  but 
having  held  no  communication  which  is  liable  to  convey  infection,  may  be 
exempted  from  the  disinfection  aud  detention  impo.sed  on  merchant  vessels 
from  such  ports.  (Quarantine  Laws  and  Regulations,  Treasurv  Department, 
1910.  arts,  146-148.) 

2733.  On  entering  port,  in  addition  to  the  bill  of  health,  the  senior  medical 
officer  of  the  ship  shall  be  prepared  to  furnish  the  quarantine  officer,  if 
required,  with  a  statement  relative  to  the  health  conditions  prevailing  on 
board  ship.  Certain  diseases  of  a  contagious  or  infectious  character,  not 
included  among  the  quarantinable  diseases  under  the  quarantine  laws  and 
regulations  of  the  Treasury  Department,  such  as  the  exanthemata,  diphtheria, 
cerelirospinal  meningitis,  etc.,  will  ordinarily  be  viewed  by  local  or  State 
authorities  as  constituting  quarantinable  diseases  and  their  pre.sence  on  board 
should  be  considered  as  rendering  the  vessel  subject  to  quarantine  restric- 
tions.   All  such  diseases  should  be  fully  reported  to  the  inspecting  health  officer. 

2734.  If,  in  the  opinion  of  the  quarantine  officer,  a  pilot  has  been  exposeil  to 
infection  upon  boarding  a  vessel  with  quarantinable  di.sense  on  board,  he  may 
be  detained  in  quarantine  a  sufficient  length  of  time  to  cover  the  period  of 
incubation  of  the  disease  in  question.  (Quarantine  Laws  and  Regulations. 
1910.) 

2735.  .Jurisdiction  in  matters  of  sanitation  and  quarantine  in  the  waters  of 
Colon  and  Panama  is  exercised  by  the  United  States  authorities  of  the  Canal 
Zone,  and  in  the  ca.se  of  vessels  entering  the  ports  of  Colon  and  Panama. 
In  all  ports  in  the  Canal  Zone  original  bills  of  health  in  duiillcate  are  required 
to  be  obtainefl  by  masters  of  vessels  clearing  from  any  foreign  port  or  any  port 
In  the  possessions  or  other  dependeucies  of  the  United  States.  (Executive  Order 
No.  1761,  of  Apr.  15,  1913.) 

Section  4. — Pills  of  Health. 

2741.  (a)  Naval  vessels  clearing  from  one  United  States  port  for  another 
United  States  port  do  not  ordinarily  procure  a  bill  of  health  for  presentixtion 
at  the  port  of  arrival.  Local  or  State  authorities  at  the  i)ort  of  arriv.nl  niay, 
however,  re<iuire  the  exh'bltlon  of  a  bill  of  health  \inder  s])ecial  circumst:)U<xs. 
su<'h  as  when  some  epidemic  disease  exists  at  the  ]wvt  of  departure,  .md  nnder, 
such  circumstances  it  is  advisable  for  the  medical  officer  to  procure  a  bill  of 
health. 

In  certain  ports  of  the  United  States  both  National  and  State  quarantine 
regulations    are    enforced,    so    that    pratique    may    have    to    be    claimed    and 


MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY.        205 

obtained  from  both.  Quarautine  expenses  (bills  of  health  and  pratique)  are 
a  charge  against  "Pay,  miscellaneous."  (For  decision  as  to  the  liability  of  a 
naval  vessel  for  the  payment  of  quarantine  charges  growing  out  of  a  State 
law,  see  Official  Opinions  of  the  Attorney  General,  1906,  vol.  25,  p.  234.) 

(b)  A  naval  vessel  from  a  United  States  port  to  a  port  in  the  Canal  Zone  or 
the  possessions  or  other  dependencies  of  the  United  States  should  secure  a 
bill  of  health  from  the  customhouse,  or  the  port  authorities  or  other  official. 
(In  some  ports  a  medicftl  officer  of  the  Public  Health  Service  is  authorized 
to  issue  bills  of  health.) 

(c)  Naval  vessels  sailing  from  a  United  States  port  to  a  foreign  port  should 
always  procure  a  bill  of  health  from  the  proper  authorities  and  have  It  viseed 
by  tlie  consular  or  other  representative  of  the  country  or  countries  of  ports  of 
call,  if  such  ports  can  be  determined  upon  prior  to  sailing.  It  is  sometimes 
advisable  to  secure  bills  of  health  for  several  ports  to  which  the  vessel  might 
go,  when  definite  information  of  the  exact  destination  is  not  procurable.  A 
naval  vessel  sailing  from  a  foreign  port  to  another  foreign  port  should  likewise 
procure  and  have  viseed  a  bill  of  health. 

(d)  A  vessel  leaving  a  foreign  port  for  a  home  port  should  obtain  a  bill  of 
health  from  a  port  official  and  also  a  United  States  consular  bill  of  health  at  a 
port  where  the  i.^sue  of  c-:>nsular  bills  of  health  is  customary  or  from  Unitetl 
States  public  health  officer  if  one  is  stationed  there. 

(e)  The  following  data  are  usually  required  when  applying  for  a  bill  of 
health : 

Name  of  vessel. 

Tonnage. 

Number  of  guns. 

Name  of  captain. 

The  number  of  souls  on  board. 

Destination. 

2742.  Supplemental  bills  of  health  (if  call  is  made  at  some  hitermediate 
port  or  ports)  should  be  obtained  and  be  properly  viseed.  "Vessels  clearing 
from  a  foreign  port  or  from  any  port  in  the  possessions  or  other  dependencies 
of  tlie  United  States  for  any  port  in  the  United  States,  its  possessions  or  other 
dependencies,  and  entering  or  calling  at  intermediate  ports,  must  procure  at 
all  said  ports  a  supplemental  bill  of  health  in  duplicate  signed  by  the  proper 
officer  or  officers  of  the  United  States,  as  provided  in  the  law.  If  a  quaran- 
tinable  disease  has  appeared  on  board  the  vessel  after  leaving  the  original  port 
of  departure,  or  other  circumstances  presumably  render  the  vessel  infected, 
the  supplemental  bill  of  health  should  be  witheld  until  such  sanitary  measures 
have  been  taken  as  are  necessary."     (Quarantine  Laws  and  Regulations,  1910.) 

2743.  Bills  of  health  for  naval  vessels  in  the  fleet  may  be  procured  for  the 
fleet  as  a  whole  by  the  fleet  surgeon  if  no  diversion  of  individual  ships  is  con- 
templated. Bills  of  health  for  individual  ships  should  always  be  procured,  how- 
ever, in  the  absence  of  orders  to  the  contrary,  in  view  of  the  fact  that  a  ship 
may  at  any  time  be  detached  from  the  fleet  and  ordered  to  operate  singly. 

The  medical  officer  of  a  ship  is  not  relieved  from  responsibility  for  the  health 
of  his  ship's  personnel  by  the  activities  of  division  or  fleet  surgeon  and  should 
personally  ascertain  and  keep  his  commanding  officer  informed  of  the  health  of 
every  port  visited. 

2744.  Bills  of  health  for  naval  vessels  and  indorsement  by  consular  officers 
are  usually  extended  gratis.  Any  expense  involved  in  procuring  bills  of  health 
or  in  quarantine  is  a  charge  against  appropriations  not  under  the  Bureau  of 
Medicine  and  Surgery. 

2745.  In  the  United  States  a  medical  officer  procures  a  bill  of  healtli  by 
applying  in  person  at  the  customhouse  or  collector  of  the  port's  office  or  to  the 
representative  of  the  United  States  Public  Health  Service. 

In  foreign  ports  request  for  a  bill  of  health  should  be  made  at  the  ofiice  of 
the  captain  of  the  port  (Bureau  du  Capitaine  du  port,  Uffizio  dell  Capitano 
dell  Porto,  Capitania  del  Puerto). 


206        MANUAJ.   FpK.XHK   MEDICAl.   DJipAJUMENT,   U^    if.   N^V^ 

The  medical  officer  should  take  with  hiiii  bills  of  hciilth  from  hist  porr  of 
departure  and  be  prepared  to  furnish  the  details  given  above  (2741f).  If 
epidemic  or  contagious  diseases  are  present  at  the  time  of  making  the  request, 
a  visit  should  also  be  made  to  the  consul  of  the  nationality  of  the  next  port  of 
call  (particularly  in  the  Mediterranean)  for  his  vis^^. 

Section. — 5. — Disinfection  and  Distofectants. 

PHYSICAL  disinfectants. 

2751.  (a)  Sunlight.— Birect  sunlight  will  kill  pathogenic  bacteria  after  vary- 
ing times  of  exposure.  For  instance,  plague  bacilli  are  killed  in  less  than  an 
hour,  while  tvphoid  organisms  require  six  hours'  exposure.  The  violet  and  ultra- 
violet rays  are  the  most  active,  the  red  and  yellow  rays  boing  practically  inei-t. 
\  (b)  Burning.— Ot  unquestioned  efficiency  but  seldom  practiced  on  account  of 
expense. 

(c)  Boilinff. — Boiling  is  very  efficient,  especially  In  a  solution  of  carbonate  of 
soda,,l  per  cent  strength,  for  at  least  one-half  hour,  preferably  one  hour. 
Articles  to  be  disinfected  must  be  wholly  immersed  and  the  solution  nmst  be 
actually  boiling  for  the  required  period  of  dis=infection.  Nonspore-bearing  bac- 
teria are  killed  by  short  immersion  in  boiling  water  at  sea  level.  In  elevated 
regions  one  should  remember  that  the  boiling  temperature  is  lower. 
■  id)  ,Sffeflw.— Flowing  steam  (not  under  pressure)  when  applied  under  suit- 
able conditions  is  an  efficient  disinfecting  agent.  The  exposure  must  be  con- 
tinued 30  minutes  after  the  temperature  has  reached  100  C.  Steam  under 
pressure  will  sterilize  efficiently  provided  the  process  is  continued  20  minutes 
after  the  pressure  reaches  15  pounds  per  square  inch.  The  air  must  be  expelled 
from  the  apparatus  at  the  beginning  of  the  process.  If  impracticable  to  obtain 
the  designated  pressure,  a  correspondingly  longer  exposure  will  accomplish  the 
same  result.  The  best  method  of  applying  steam  under  pressure  is  to  apply 
it  in  a  special  apparatus  with  vacuum  attachment,  the  object  of  the  vacuimi 
apparatus  being  to  expel  the  air  and  to  promote  the  penetration  of  the  steam. 
The  process  is  to  be  continued  for  20  minutes  after  the  pressure  reaches  10 
pounds  to  the  square  inch. 

GASEOUS    disinfectants. 

2762.  (a)  Sulphur  dtoatd.— This  is  a  weak  germicide,  but  a  potent  insecti- 
cide; to  be  efficient  it  requires  tlie  presence  of  moisture.  It  is  only  a  surface 
disinfectant  and  is  lacking  in  penetrating  properties.  An  atmosphere  contain- 
ing 4.-5  per  cent  can  be  obtained  by  burning  5  poumls  of  sulphur  per  1,000 
cubic  feet  of  space.  This  amount  requires  the  evaporation  or  volatilization  of 
about  1  pint  of  water.  Under  tliese  conditions  tlie  time  of  exposure  sliouM  be 
not  less  than  24  hours  for  bacterial  infections.  A  sliorter  time  will  suffice  for 
fumigation  necessary  to  kill  mosquitoes  ami  other  vermin.  Dry  sulphur  dioxid 
produced  by  burning  2  pounds  of  sulphur  for  each  1,000  cubic  feet  of  space 
will  answer  for  this  purpose.  An  exposure  of  from  fwo  to  three  hours  is  suffi 
cient  The  sulphur  may  be  burned  in  shallow  iron  pols  (Dutch  ovens),  con- 
taining not  more  than  80  pounds  of  sulphur  to  each  iwt,  and  the  pots  should 
stand  in  vessels  of  water.  The  sulphur  pots  sliould  be  plovate<l  from  the  bot- 
tom ot  the  compartment  to  be  dlsinfecte<l  in  order  to  ohmin  the  maximum 
possible  percentage  of  combustion  of  sulphur.  The  sulpiun-  should  be  in  a 
state  of  fine  division,  and  ignition  is  best  accoinpllslied  witli  alcohol  (spet-lal 
.•are  being  taken  with  this  method  to  prevent  damage  to  cargo  or  vessel  by  tire), 
or  the  sulphur  may  be  burnea  In  a  special  furnace,  the  sulphur  dioxid  being 
distributed  by  a  power  fan.  This  method  is  peculiarly  applicable  to  cargo  ves- 
sels Liquefied  sulphur  dioxid  may  be  used  for  disinfecti(.n  in  place  of  sulphur 
<11oxid  generat'Hi  as  above,  It  being  borne  in  mind  that  this  pi-ocess  will  require 


MANUAL   i'OK   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY.        207 

2  puiuHls  of  the  liqueiied  gas  for  each  pound  of  sulphur,  as  indicated  in  the 
above  paragraph.  Sulphur  dioxid  is  especially  applicable  to  the  holds  of  vessels 
or  to  compartments  that  may  be  tightly  closed  and  that  do  not  contain  objects 
that  would  be  injui-ed  by  gas.  Sulphur  dioxid  bleaches  fabrics  or  materials  dyed 
with  vegetable  or  aniline  dyes.  It  destroys  linen  or  cotton  goods  by  rotting  the 
fiber  through  the  agency  of  the  acids  formed.  It  injures  most  metals.  It  is 
l»i-omptly  destructive  of  all  forms  of  animal  life.  This  property  renders  it  a 
valuable  agent  for  the  extermination  of  rats,  insects,  and  other  vermin.  Sul- 
phur dioxid  is  a  germicide  only  in  the  presence  of  moisture,  and  even  then  will 
not  kill  spore-bearing  organisms.  If  clothing  is  washed  immediately  after  sul- 
phur di-sinfection,  the  rotting  effect  will  be  greatly  lessened.  If  used  in  spaces 
containing  machinery,  all  metal  parts  should  be  coated  with  vaseline. 

(b)  Formaldehyde. — Formaldehyde  is  effective  as  a  surface  disinfectant  if 
applied  by  one  of  the  methods  given  below.  Formaldehyde  gas  has  the  advau- 
tage  as  a  disinfectant  that  it  does  not  injure  fabrics  or  most  colors.  It  is 
valueless  as  an  insecticide  and  fails  to  kill  vermin,  such  as  rats,  mice,  roaches, 
bedbugs,  etc.  It  is  not  applicable  in  the  <iisinfection  of  holds  of  large  vessels. 
Formaldehyde  is  used  in  the  disinfection  of  rooms,  clothing,  and  fabrics,  but 
should  not  be  depended  upon  for  bedding,  upholstered  furniture,  mattresses,  and 
the  like,  where  deep  penetration  is  required.  The  temperature  should  be  above 
50  F.,  and  there  should  be  at  least  60  per  cent  of  moisture  for  efficient  formal- 
dehyde disinfection.  Many  formaldehyde  solutions  (formalin)  do  not  contain 
40  per  cent  of  formaldehyde  owing  to  evaporation  or  deterioration,  and  it  is 
advisable  to  use  a  quantity  in  excess  of  the  amount  prescribed  in  these  regula- 
tions. It  is  not  efficient  in  cold  dry  rooms.  The  method  of  producing  formalde- 
hyde gas  by  pouring  formalin  on  potassium  permanganate  is  one  of  the  most 
I'onvenient  and  efficient  of  the  various  methods  and  has  largely  replaced  the 
more  expensive  autoclaves  and  lamps.  To  prepare  a  room  for  disinfection, 
measure  the  net  cubic  space  and  calculate  the  amounts  of  ingredients  required. 
Allow  500  c.  c.  of  formalin  and  2.50  grams  of  potassium  permanganate  for  each 
1,000  cubic  feet  of  space.  Paste  up  with  paper  strips  all  cracks  and  openings. 
Then  take  a  pan  partly  tilled  with  water.  Place  in  this  a  second  metal  or 
glass  receptacle  containing  the  permanganate.  Then  pour  the  formalin  on  the 
permanganate  crystals.  The  gas  is  generated  in  great  amount  in  a  few  sec- 
onds. The  receptacle  containing  the  formalin  and  permanganate  should  be 
large  enough  to  contain  10  times  the  volume  of  forni:din,  as  there  is  a  tendency 
for  the  mixture  to  foam  over  the  sides  of  the  dish.  The  room  or  compartment 
should  be  closed  tightly  for  6  to  12  hours  and  then  flooded  with  air  and  sunshine 
if  possible. 

Another  practical  method  is  the  formalin  sheet-spraying  one.  The  formalin 
(4C  per  cent)  should  be  sprayed  on  sheets  suspended  in  the  room  in  such  a 
manner  that  the  solution  remains  in  .small  drops  on  the  sheet.  Spray  not  less 
than  10  ounces  of  formalin  (40  per  cent)  for  each  1,000  cubic  feet.  Used  in  this 
way  a  sheet  will  hold  about  5  ounces  without  dripping  or  the  drops  running 
together.  The  room  must  be  very  tightly  sealed  in  disinfecting  with  this 
process  and  kept  closed  not  less  than  12  hours.  The  method  is  limited  to  rooms 
or  compartments  not  exceeding  2,0(X)  cubic  feet.  The  formalin  may  also  be 
sprayed  upon  the  walls,  floors,  and  objects  in  the  room.  For  single  rooms  the 
use  of  a  paraform  lamp  is  quite  convenient.  Special  lamps  can  be  obtained  to 
burn  the  paraform  tablets  or  a  pint  tin  cup  will  suffice  for  the  heating  of  1 
ounce  of  paraform.  The  lamp  or  alcohol  tlame  under  tlie  receptacle  must  not 
be  high  enough  to  ignite  the  paraform,  which  burns  readily  and  in  .so  doing  does 
not  give  off  formaldehyde  gas.  One  ounce  of  paraform  is  sufficient  for  a  space 
bf  500  cubic  feet.  One  can  dissolve  2  ounces  of  paraform  in  8  ounces  of  boiling 
water  and  then  pour  this  over  4  ounces  of  potassium  permanganate  in  a  2-gallon 
pail.  After  a  prolonged  series  of  tests  the  Department  of  Health  of  New  York 
City  prefers  the  following  method:  Formaldehyde,  30  grams;  potassium  pej;r 
manganate,  75  grams;  water,  90  grams.     The  chemicals  are  mixed  in  a  deep 


208        MANUAL   FOR   THE    MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

quart  pan,  uiul  the  water  is  added  and  the  ndxtnre  stirred.  Tlie  evolution  of 
Kas  is  slow  in  startinj.'.  but  is  complete  in  H  to  10  niinutes.  It  was  found  that 
87  per  cent  of  the  gas  was  evolved  and  the  quantities  given  above  suffice  to 
disinfect  1.00()  cubic  feet  in  four  hours.  It  is  well  to  put  the  small  pan  con- 
taining the  chemicals  in  a  larger  one  to  prevent  danger  of  tire  and  soiling  of  thr- 
floor  by  the  frothing  of  the  mixture.  Bromine,  chlorine,  and  hydrocyanic  acid 
have  marked  disinfectant  properties,  but  are  very  dangerous  and  are  not  at 
present  adapted  for  practical  application. 

(c)  Hydrovmnic.  acid. — Hydrocyanic  acid  gas,  mixed  with  the  internal  atmos- 
phere of  the  ship  in  the  proper  proportions,  will  quickly  and  certainly  kill  all 
air-breathing  animals  exposed;  it  will  penetrate  into  the  interior  of  porous 
bodies,  such  as  mattres.ses,  hammocks,  and  bags,  in  a  short  time ;  and  in  a 
longer  time  into  closed  drawers,  trunks,  and  other  containers  of  gas-tight 
material  having  pervious  joints  and  cracks.  If  those  engaged  in  the  work  are 
properly  equipped  and  are  supervised  with  reasonable  skill  and  care,  there  is 
practically  uo  danger.  The  gas  is  physically  and  chemically  inert,  and  does  no 
damage  to  structures,  machinery,  stores,  or  personal  effects  (although  a  .small 
quantity  of  acid  spray  is  thrown  off.  which  may  cause  a  slight  tarnishing  of 
bare  metal  near  the  generator),  and  there  is  no  danger  of  fire. 

The  process  is  essentially  very  simple;  a  quantity  of  solid  sodium  cyanid  is 
dropped  into  a  bucket  containing  a  mixture  of  sulphuric  acid  an<l  water,  the 
operator  at  once  escapes,  tightly  closes  the  compartment  behind  him,  and 
leaves  the  gas  to  generate,  diffuse,  and  penetrate  for  from  1  tn  48  hours, 
according  to  circumstances,  after  which  the  compartment  is  opened  and  thor- 
oughly ventilated,  preferably' by  blowers;  all  of  which,  except  the  planning 
necessitated  by  the  intricate  construction  of  modern  warships,  reqinres  little 
time  and  skill,  and  not  very  much  labor. 

The  material  is  used  in  the  following  proportions  for  each  1,000  cubic  feet 
of  space ;  5  ounces  of  sodium  cyanid,  Ti  fluid  ounces  of  sulphuric  acid,  and  10 
ounces  of  water. 

The  gas  is  harmless  to  material  of  all  kinds,  thus  making  it  unnecessary  to 
remove  anything  from  the  ship.     There  is  no  danger  from  tire. 

It  penetrates  easily  into  any  but  air-tight  containers,  making  it  unnecessary 
to  spread  out  bedding  and  clothing. 

There  is  no  lingering  odor  in  compartments  or  clothes. 

CHEMICAL  SOLUTIONS. 

2753.  (a)  Bichlorid  of  mercury. — As  a  chemical  disinfectant  corrosive  sub- 
limate or  bichlorid  of  mercury  in  solution  h.'is  been  used  quite  extensively.  It 
has  some  marked  di-sadvantages,  however,  which  tend  to  limit  its  usefulness. 
It  has  a  destructive  action  on  metals  and  must  be  placed  in  wooden  or  earthen- 
ware ves.sel.s.  It  can  not  be  used  to  disinfei.'t  any  material  containing  albumen, 
since  it  forms  inert  ali)nminates.  It  acts  as  a  mordant  and  fixes  stains  in  soiled 
fabrics.  It  Is  very  poisonous  and  its  solutions  should  not  be  used  to  disinfect 
dishes  to  be  used  later  for  food.  Solutions  of  bichlorid  of  mercury  in  distilled 
water  after  a  time  become  reduced  in  stren,!;th  through  the  formation  of  oxychlo- 
rid,  and  nil  solutions  are  incompatible  with  alkalies  and  their  carbonates,  lime- 
water,  soaps,  and  most  metallic  salts.  As  a  disinf»"ct:int  bichlorid  of  mercury 
Is  commonly  used  in  a  strength  of  1-1,000,  adding  to  the  water  used  for  solution 
2  parts  per  1.000  of  sodiiun  or  iimmonium  chlorld.  The  material  to  be  disin- 
fected should  be  immersed  in  the  solution  (contained  in  an  earthenware  or 
wooden  vessel)  for  at  Icnst  an  hour,  and  walls  and  floors  may  be  si-rubbed  down 
with  the  solution  which  Is  allowed  to  dry  on  them. 

(The  binlodid  of  mercury  po.ssesses  material  advantagi-s  as  a  disinfectant 
over  the  bichlorid,  but  owing  to  its  greater  expense  is  not  generally  used,  except 
as  a  surgical  disinfectant.     It  is  a  more  powerful  germicide,  does  not  coagulate 


MANUAL   FOR    THE    MEDICAL   DEPAETMENT,    U.    S.    NAVY,        209 

albumen,  nor  cause  precipitation  witli  pus  or  blood  unless  they  are  in  excess, 
is  more  penetrating,  less  irritating  to  tlie  skin  and  to  wounds,  less  toxic,  and 
does  not  cause  innnediate  corrosion  of  metals.) 

(6)  Carbolic  acid  {phenol). — The  standard  solution  of  carbolic  acid  is  5  per 
cent,  commonly  spoken  of  as  1  in  20.  To  make  this  solution  pure  carbolic  acid 
crystals  should  be  melted  over  a  water  bath  and  hot  water  gradually  added. 
It'is  an  efhcieut  disinfectant  and  is  the  standard  for  standardizing  disinfectants. 
Owing  to  its  expense  other  members  of  the  same  group  have  been  introduced 
for  general  disinfectant  purposes.  Among  the  more  efficient  and  convenient  of 
these  is  cresol.  as  Liquor  Cresolis  Comp.,  U.  S.  P.  This  may  be  made  by  mixing 
1  part  of  cresol  and  1  part  of  soft  soap  and  letting  stand  over  night.  The 
resulting  compound  makes  a  perfect  solution  with  water,  and  a  1  in  20  solution 
is  considered  equal  to  a  5  per  cent  phenol  solution.  Liquor  Cresolis  Comp.  has 
a  disinfectant  value  of  3  (phenol  being  1),  lysol  2.12,  creolin  3.25,  and  trikresol 
2.62.  Feces,  urine,  sputum,  etc.,  to  be  disinfected  should  remain  in  contact 
with  an  equal  quantity  of  the  cresol  compound  in  5  per  cent  solution  for  an 
hour.  A  5  per  cent  solution  of  the  cresol  compound  is  suitable  for  disinfecting 
spit  kids,  contaminated  clothing,  and  the  walls  and  decks  of  compartments. 
Lysol,  creolin,  cyllin,  izal,  and  trikresol  are  other  members  of  this  group,  but 
are  too  expensive  for  general  use. 

(c)  Formalin.— FormoAm  containing  40  per  cent  of  formaldehyde  may  be 
used  in  a  5  per  cent  solution  (connnercial  formalin  .50  c.  c,  water  950  c.  c.)  as  a 
substitute  for  bichlorid  of  mercury  or  carbolic  acid,  and  is  useful  for  the  disni- 
fection  of  surfaces,  fabrics,  and  a  great  variety  of  objects,  owing  to  its  non in- 
jurious character.  It  is  also  an  excellent  deodorant.  Formalin  to  act  effi- 
ciently nmst  be  in  at  least  a  5  per  cent  solution.  For  instance,  if  a  pint  of  feces 
is  to  be  disinfected,  1  pint  of  a  10  per  cent  formalin  solution  should  be  used,  the 
mixture  to  stand  for  one  hour. 

(d)  Lime. — It  must  be  remembered  that  air  slaked  lime  is  inert  as  a  disin- 
fectant. For  disinfecting  feces,  freshly  prepared  milk  of  lime  is  excellent.  It 
is  made  by  mixing  unslaked  lime  with  four  times  its  volume  of  water.  An  equal 
quantity  should  be  added  to  the  feces  to  be  disinfected. 

(e)  Clilorinaicd  lime. — This  can  be  purchased  in  air-tight  containers  and 
when  the  package  is  opened  it  should  give  off  a  powerful  odor  of  chlorine.  For 
a  working  disinfectant  solution  add  1  pound  to  4  gallons  of  water.  This  is 
satisfactory  for  mopping  floors  and  for  disinfecting  feces,  sputum,  and  urine, 
equal  parts  of  the  excreta  and  disinfecting  solution  being  mixetl  and  allowed  to 
stand  for  one  hour.  For  disinfection  of  drinking  water  one  teaspoonful  of 
chlorinated  lime  to  1  pint  of  water  makes  a  stock  disinfectant.  For  use  1  tea- 
spoonful  of  this  stock  solution  is  added  to  2  gallons  of  drinking  water.  Let 
stand  at  least  one-half  hour. 

Section  6. — Application  of  Disinfectants  in  Disinfection. 

2761.  Holds  of  iron  ve.ssels,  empty,  shall  be  disinfected  by  either — 

(o)  Sulphur  dioxid  generated  by  burning  sulphur  5  pounds  per  1,000  cubic 
feet  of  air  space,  or  liberated  from  10  pounds  of  liquid  sulphur  dioxid,  sufficient 
moisture  being  present  in  both  cases.     Time  of  exposure,  twenty-four  hours. 

{b)   Washing  with  a  solution  of  bichlorid  of  mercury,  1-1,000. 

(c)  Hydrocyanic  acid  gas. 

2762.  Holds  of  wooden  vessels,  empty,  shall  be  disinfected  by — 
(«)    Sulphur  dioxid  in  the  manner  prescribed  above,  followed  by— 
(b)   Washing  with  a  solution  of  bichlorid  of  mercury. 

(c) Hydrocyanic  acid  gas. 

2763.  In  the  case  of  all  vessels,  both  iron  and  wooden,  when  treated  for 
yellow  fever  or  plague  infection,  the  first  process  shall  be  preliminary  fumiga- 
tion by  sulphur  dioxid  or  hydrocyanic  acid  in  the  manner  previously  stated 

98601°— 17 14 


210        MANUAL   FOR    THK    MKDICAL   DEPARTMENT,  U.    S.    NAVY. 

(par.  '27.j2)   in  order  to  insure  the  destruction  of  mosquitoes,  rats,  and  otln^r 
vermin. 

2764.  Holds  of  cargo  vessels,  when  cargo  can  not  be  removed,  shall  be  dis- 
infected in  so  far  as  possible  by  either  hydrocyanic  acid  gas  or  sulphur  dioxid, 
the  latter  not  less  than  4  per  cent  \h>v  volume  .strength,  and  where  possible  thi.s 
should  be  generated  from  a  furnace  to  minimize  danger  of  fire  in  cargo. 

2765.  Living  compartments,  cabins,  and  forecastles  of  vessels  shall  be  dis- 
infected by  one  or  more  of  the  following  methods: 

(a)  Sulphur  dioxid,  the  destructive  action  of  the  gas  on  property  \hh\\^' 
borne  in  mind.  I 

(h)   Formaldehyde  gas.  - 

(c)  Hydrocyanic  acid  gas. 

(d)  Washing  with  solution  of  bichlori<l  of  mercury,  1-1,000,  or  5  per  cent 
solution  of  formalin,  or  5  per  cent  solution  of  carbolic  acid,  preference  being- 
given  to  carbolic  acid  for  application  to  polished  woods,  bright  metals,  tind  other 
objects  injured  by  metallic  salts. 

2766.  The  forecastle,  steerage,  and  other  living  compartments  in  bad  sanitary 
condition  must  be  disinfected  by  method  (a),  followed  by  method  (c). 

2767.  Mattresses,  pillows,  and  heavy  fabrics  are  to  be  disinfected  by — 
(o)  Boiling. 

(b)  Flowing  steam — i.  e.,  steam  not  under  pressure. 

(c)  Steam  under  pressure. 

(c?)   Steam  iu  special  apparatu^  with  vacuum  attachmenl. 

2768.  Clothing,  fabrics,  textiles,  curtains,  liangings,  etc.,  may  be  treated  by 
t'ither  of  the  above  methods  from  (a)  to  id),  inclusive,  as  circunistances  may 
demand,  or  by  formaldehyde  gas  or  sulphur  dioxid  where  the  article  is  of  a 
•character  which  will  not  be  injured  by  sulphur  dioxid. 

2769.  Articles  injured  by  steam,  such  as  leather,  furs,  skins,  rubber,  trunks, 
valises,  liats  and  caps,  bound  books,  silks,  and  fine  woolens  should  not  be  disin- 
fected by  steam.  Such  articles  should  be  disinfected  by  formaldehyde  gas  or 
any  of  the  agents  above  mentioned  which  may  be  applicable  thereto.  Those 
which  will  be  injured  by  wetting  should  l)e  disinfected  by  a  gaseous  agent. 

2770.  Clotliing,  textiles,  and  baggage,  clean  and  in  good  condition,  but  sus- 
pected of  infection,  can  be  efficiently  and  least  injuriou.sly  disinfected  by  for- 
maldehyde gas,  generated  by  one  of  the  methods  described.     (Par.  2752  (b).) 

2771.  Textiles  which  are  soiled  with  discharges  of  the  sick  or  pre.sumably 
are  deeply  infected  must  be  disinfected  by — 

(a)   Boiling. 

(&)   Steam. 

(c)    Immersion  in  one  of  the  germicidal  sohition.s. 

2772.  Cooking  and  eating  utensils  are  always  to  be  disinfected  by  immersion 
in  boiling  water  or  by  steam.     (United  States  Quarantine  Instructions,  1010.) 

Section  7, — Insecticides. 

2781.  The  following  notes  are  taken  chiefly  from  the  United  States  Quaiau- 
tine  Instructions.  1910: 

Sulpliur  dioxid,  obtained  as  descrlbetl  above,  destroys  all  animal  life. 

In  the  case  of  vessels,  when  treated  for  yellow  fever  Infection,  the  process 
shall  be  a  fumigation  with  sulphur  dioxid,  2  per  cent  volume  gas.  and  two 
hours'  exposure  in  order  to  Insure  the  destruclion  of  mo.s(iuitoos. 

In  the  case  of  vessels  when  treated  for  plague  the  process  with  sulphur  <lioxid 
shall  be  as  follows: 

Witiiout  cargo:  The  fumigation  with  sulphur  dioxid  gas  not  less  liian  2  jx-r 
••ent  for  six  hours'  exposure. 

With  cargo:  Fumigation  with  sulphur  dioxid  gas.  4  i)cr  cent,  G  (o  12  lioiirs' 
exposure,  according  to  stowing. 


MANUAJ,   FOR    THE    MEDICAL    DKPAKTMKNT,    U.    S.    NAVY.        211 

Infected  vessels  may  require  conii»iele  or  partial  <iis(iiarge  of  cargo,  aud 
fractional  fumigation  for  efficient  deratizatiou. 

Pyrethnim:  The  fumes  of  burning  pryethrum  may  he  used  to  destroy  mos- 
quitoes in  places  where  there  ai'e  articles  liable  to  be  injured  by  the  use  of 
sulphur. 

Four  pounds  per  1,000  cubic  feet  space  for  two  hours'  exposure ;  with  this 
amount  all  or  practically  all  of  the  mosquitoes  will  lie  killed,  but  pi'ecautions 
should  be  taken  to  sweep  up  and  destroy  any  that  ma\  have  escaped  (l<'<;lruc- 
tion.     Pyrethi-um  stains  walls.  p;iper,  etc. 

The  oxids  of  carbon  are  elficient  to  destroy  rats,  but  do  not  kill  lleas  or 
other  insects.  They  are  obtained  by  burning  carbon,  coke,  or  charcoal  in 
special  apparatus,  and  the  gas  as  produced  consists  of  ab<iut  H  per  cent  carbon 
monoxid,  18  per  cent  carbon  dioxid,  and  77  per  ceni  nitrogen. 

Twenty  kilos  of  carbon,  coke,  or  charcoal  are  used  for  ever.v  1,000  meters 
of  space.  The  gas  is  allowed  to  remain  in  the  ship  for  two  hours,  and  fi-om 
.seven  to  eight  hours  are  allowed  for  it  to  leave.  This  is  about  eqmvalent  to  1^ 
pounds  of  carbon  (coke)  to  1.000  cubic  feet  of  air  space.  As  this  gas  is  very 
fatal  to  man  and  gives  no  warning  of  its  presence,  being  odorless,  a  small 
amount  of  sulphur  dioxid  should  be  added  to  give  warning  of  its  pre.sence.  As 
it  does  not  kill  fleas  it  can  not  be  depended  upon  for  complete  work,  where 
there  is  evidence  of  plague  among  rats  on  the  vessel,  as  the  infected  fleas 
would  infect  the  rats  coming  aboard  after  the  deratizatiou. 

The  articles  named  as  disinfectants  which  can  obviously  destroy  animal  life 
can  be  used  for  that  purpose  A\lien  applicable,  as  steam  for  bedding,  f;tbrics. 
etc.     Formaldehyde  is  not  applicable  for  this  purpose.  • 

For  fleas  the  best  insecticides  are  (1)  crude  petroleum  (fuel  oil),  (2)  an 
emulsion  of  kero.sene  oil  made  as  follows:  Kerosene  20  parts,  soft  soap  1  part, 
and  water  5  parts.  The  soap  is  dissolved  in  the  water  by  aid  of  heat  and  the 
kerosene  oil  gradually  stirred  into  the  hot  mixture. 

For  cockroaches  there  is  nothing  so  good  as  sodium  fluorid.  By  .sprinkling 
the  powder  about  the  hainits  of  the  cockroaches  they  are  gotten  rid  of  ifi 
a  few  days. 

For  exterminating  rats  in  this  way  and  secondarily  the  rat-fleas,  besides  the 
ordinai-y  poisons,  such  as  arsenic,  phosphorus,  etc.,  Rucker  has  recommended 
a  poison  composed  of  plaster  of  Paris  6  parts,  pulverized  sugar  1  part,  and  flour 
2  parts.  This  mixture  .should  be  expo.sed  in  a  dry  place  in  open  dishes.  To 
attract  the  rats  the  edge  of  the  dish  may  be  smeared  with  the  oil  in  which 
sardines  have  been  packed. 

Wise  and  Minett  report  good  i-esults  from  the  use  of  crude  carbolic  acid  as  a 
larvicide  for  mosquitoes.  They  added  about  1  teasiuxinfid  for  each  2  cubic 
feet  of  water  in  the  pool.  Of  course  the  ordinary  motliod  for  destroying  mos- 
quito larvfE  is  by  covering  the  surface  of  the  water  in  tlie  cistern  or  pooi  with 
a  layer  of  petroleum  (one  ounce  of  petroleum  to  every  15  square  feet). 

Section  8. — Disinfecting  Pi.a.nts. 

2782.  The  following-named  quarantine  stations  of  the  United  .States  Public 
Health  Service  are  prepared  to  perform  disinfection  and  fumigation  when 
called  upon.  At  some  of  the  smaller  stations  a  reasonable  length  of  notice 
would  be  necessary  in  order  that  the  fumigating  materials  might  be  procured, 
as  these  stations  are  not  prepared  to  handle  large  vessels  as  a  routine  matter. 
The  fact  that  some  of  the  stations  are  not  provided  with  wharfage  facilities 
is  not  an  index  to  the  capacity  of  the  station  for  performing  disinfection.  (May, 
1917.) 


212         MA^iUAI.    FVn    THE    MEDICAL    DEPARTMENT,   U.    S.    NAVY. 


Depth  of 
water  in 
front  of 

wharf,  feet. 


Detention 
facilities 

(barracks), 
persons. 


Hospital 
beds. 


Portland,  Me 

iiecdy  island,  Del 

t  ape  >.  harles,  Va 

(  harlesion,  S.  (" 

Tamp.)  Hay,  Fla 

Mobile,  Ala 

Oahestou,  Te.\ 

San  Francisco,  Cal 

Columbia  iUver,  Ureg . 

San  Juan,  1*.  H 

ISoston,  Mass 

Providence,  U.  1 

Cape  Fear,  iS'.  C 

Savannah,  Ga 

Pensacola,  Fla 

New  Orleans,  La 

San  Diego,  i  al 

Port  Townsend,  Wash 
Honolulu,  Hawaii 


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CHAPTER  16. 


LINE  OF  DUTY  AND  ORIGIN  OF  DISABILITY   FROM  DISEASE  OR 

INJURY. 

Section  1. — Laws  Relating  to  Line  of  Duty,  etc.     (See  Also  "  Navy  Tension 
Fund  and  General  Pensions,"  Chapter  23.) 

2801.  Gratuity  (death  benefit)  : 

(a)  Deuth  from  wounds  or  disease  originating  in  line  of  duty.  Act  of  May 
13,  1908. 

(ft)  Death  from  wounds  or  disease  not  a  result  of  own  misconduct.  Act  of 
August  22,  1912.     R  4551  (1). 

2802.  Retirement  (officers)  : 

(a)  Retiring  for  incapacity  resulting  from  and  incident  to  service.  Sec. 
1453,  R.  S. 

(b)  Retirement  for  disability  not  an  incident  to  service.    Sec.  1454,  R.  S. 

(c)  No  officer  of  the  Navy  shall  be  placed  on  the  retired  list  for  misconduct: 
but  shall  be  brought  to  trial  by  court-martial  for  such  misconduct.  Sec. 
1456,  R.  S. 

V,  2803.  Promotion  (officers)  : 

(a)  Disability  from  wounds  incurred  in  line  of  duty  not  a  bar  to  promotion 
if  not  incapacitated  for  other  duty  of  the  higher  grade.     Sec.  1495,  R.  S. 

(b)  Officers  failing  in  physical  examination  for  promotion  on  account  of  dis- 
ability contracted  in  line  of  duty.    Sec.  1447,  R.  S. ;  act  of  March  4,  1911. 

Section  2. — Navy  Regulations  and  Naval  Instructions  Relating  to  State- 
ments AS  to  Origin  of  Adverse  Nature. 

2811.  "  Not  in  line  of  duty  "  entries.    R  2902  (1-5). 

2812.  Entries  in  record  of  an  officer  indicating  use  of  drugs  or  intoxicants. 
I  707  (5). 

2813.  When  records  are  incomplete  the  Bureau  of  Medicine  and  Surgery  is 
to  decide  origin.     R  4564. 

2814.  Court  of  ino.uiry  and  board  of  inquest;  deaths  due  to  accident.  R 
322  (3)  ;  R  323  (2)  ;  R  401  (2). 

2815.  Entries  ou  death  certificate  as  to  origin  of  disability  causing  death. 
R  2963  (2). 

2816.  Report  of  eyewitnesses  to  accidents.    R  4563. 

2817.  Reports  of  death  as  evidence  for  claim  for  pension.     R  4562. 

2818.  "Misconduct"  admissions.     Gen.  Ord.  No.  231. 

Section  3. — Information,  Decisions,  etc..  Regarding  Line  of  Duty  and  Origin 

OF  Disability. 

2820.  Hereafter  no  officer  or  enlisted  man  in  the  Navy  or  ISIarine  Corps,  in 
active  service,  who  shall  be  absent  from  duty  on  account  of  sickness  ov  dis- 
ease resulting  from  his  own  intemperate  use  of  drugs  or  alcoholic  liquors,  or 
other  misconduct,  shall  receive  pay  for  the  period  of  such  absence,  the  time 
so  absent  and  the  cause  thereof  to  be  ascertained  under  such  procedure  and 

213 


214         MAM'A).    KOi;    TPIE    MF.DIt.M.    DKPARTMENT,   U.    S.    NAVY. 

rt'-ulations  as  may  bo  iirescrila'd  by  the  Secretary  of  theNavy:  Provided,  That 
an  enlistment  shall  not  be  regarded  as  eomitlete  until  the  enlisted  man  shall 
have  made  good  any  time  in  excess  of  one  day  lost  on  account  of  sickness  or 
disease  resulting  from  his  own  intem[)erate  ns(!  of  drugs  or  alcoholic  Jiipiors 
or  other  misconduct. 

Absence  from  duty  of  any  nihi-er  or  enlisted  man  of  the  Navy,  iu  active 
service,  on  account  of  disease  resulting  from  his  own  intemjwrate  use  of  drugs 
or  alcoholic  liquors,  or  other  misconduct,  is  within  the  purview  of  the  statute 
quoted  above;  and  any  officer  or  enlisted  man  who,  on  or  after  August  29.  1916, 
has  been  absent,  or  may  hereafter  be  absent,  from  dutj  fr;)iii  any  suc!\  cause, 
or  causes,  is  not  entitled  to  pay  as  distinguished  from  allowances  for  the  period 
of  such  absence.  But  where  the  disease,  within  the  purview  of  the  statute 
quoted  above,  was  contracted  prior  to  August  -9,  1910,  as  a  result  of  which 
the  officer  or  enlisted  man  is  absent  from  duty  after  that  date,  no  deduction 
of  pay  will  be  made. 

Whene\er  an  officer  or  enlisted  man  of  the  Navy,  in  active  service,  is  absent 
fi'om  duty  on  account  of  sickness  or  disea.se.  resulting  from  his  own  intem- 
perate use  of  drugs  or  alcoholic  liquors,  or  other  misconduct,  the  medical 
officer  having  cognizance  of  the  case  shall  prepare  and  forward  lo  the 
commanding  officer  an  admission  "  Misconduct  report,"  and  ui)on  the  individual 
being  discharged  to  duty  a  discharge  "  Misconduct  report."  In  the  case  of 
officers  these  reports  shall  be  forwarded  in  dui)licate,  one  to  the  commanding 
officer,  for  further  reference  to  the  Bureau  of  Navigation,  the  other  via  the  com- 
manding officer  to  the  pay  officer  carrying  the  officer's  accounts.  In  the  case  of 
enlisted  men  the  reports  shall  be  made  in  triplicate,  if  necessary,  and  forwarded 
through  the  commanding  officer,  one  each  for  the  commanding  and  pay  officer 
carrying  the  man's  accounts,  and  the  third  for  the  officer  having  custody  of  the 
man's  service  record. 

In  tlie  case  of  erdisttMl  men,  notation  of  absence  under  the  purview  of  this 
order  will  be  made  on  the  service  record  on  the  leaf  for  recording  leaves  of 
absence.  The  date  admitted  to  the  sick  list  will  not  be  counted  as  a  day  of 
absence;  the  date  discharged  from  the  sick  list  shall  count  as  a  day  of  absence. 

When  the  medical  «)lficer  having  custody  of  the  health  record  of  an  officer 
or  enlisted  man  enters  on  such  record  that  the  sickness  or  di.sease  causing 
absence  from  duty  is  the  result  of  his  own  intemperate  use  of  drugs  or  alcohlic 
llquoi-s,  or  other  misconduct,  it  shall  be  the  duty  of  such  medical  officer  to  inform 
the  patient  when  such  adverse  entry  is  made,  provided  the  condition  of  the 
patient  does  not  make  such  action  inadvisable.  He  will  inform  the  command- 
ing officer  at  the  .same  time  in  the  manner  prescribed  above. 

When  the  commanding  officer  and  medical  officer  are  in  accord  the  entry 
shall  be  final.  Should  th«'  commanding  ofli<,*er  and  the  medical  olHcer  disagree 
the  former  will  call  a  board  of  officers  of  not  less  than  two  members,  one  of 
whom  shall  be  a  mecli(*iil  otlicer,  to  report  upon  and  make  wcomniendations  to 
him  in  the  case.  Tlie  approval  by  the  commanding  officer  of  the  findings  of  this 
board  shall  be  final  ;  but  if  the  commanding  officer  disapproves  the  findings  of 
the  board  the  proceedings  will  be  forwarded  for  the  action  of  the  next  higher 
authority.  A  copy  of  the  final  decision  In  the  case  will  be  entered  iu  the  health 
record. 

f^ommandlng  officers  are  cautioned  not  to  discharge  on  account  of  expiration 
of  enlistment  any  enlisted  man  until  he  has  made  good  the  time  in  excess  of 
one  day  lost  <»n  account  of  sickness  or  disease  resulting  from  his  own  intem- 
perate use  of  drugs  or  al<(»liolic  li(|Uors  or  other  nii.sconduct. 

2H21.  Tlic  origin  of  woumls  or  disease  resulting  in  disability  or  death  in  the 
cases  f»f  ollicers  iiiid  enlisted  men  of  the  Xavy,  whether  contracted  in  liiu>  of 
duty  or  not  in  line  of  duty,  the  result  of  own  niisc(»nduct,  or  own  vicious  habits, 
is  under  the  law  an  imi)ortant  factor  in  deciding  tlie  right  of  the  individual  to 
fXMision,  promotion,  retirement,  or  gratuity  to  beneliciary. 

As  disability  oirurring  in  the  .service  is  usually  nuide  tlie  basis  of  a  claim 
for  iK'Msioii,   special    care   will   always  be  taken   to   state  in   health    records   i  lie 


MANUAL    FOK    THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.        215 

iieyree  of  disability,  wound,  or  disease,  the  extent  to  whicli  it  deprives  the 
patient  of  the  use  of  any  limb  or  faculty,  or  affects  his  health,  strength, 
activity,  constitution,  or  capacity  to  labor.  If  such  disability  was  incurred  in 
the  line  of  duty,  and  the  patient  declined  treatment  for  the  relief  of  such  dis- 
ability where  treatment  was  directed,  that  fact  will  be  set  forth  for  the  infor- 
mation of  the  Bureau  of  Pensions. 

In  conducting  surveys  for  discharge,  it  is  enjoined  upon  all  officers  con- 
<-erned  to  observe  that  there  is  no  conflict  between  the  statements  of  medical 
officers  as  to  whether  the  disability  was  incurred  in  line  of  duty.  If  any  dis- 
crepancy exists  in  this  particular  every  possible  means  will  be  employed  to 
harmonize  the  statements  before  finally  forwarding  the  papers. 

2822.  The  pension  laws  applying  to  the  Navy,  except  in  the  cases  of  those 
pensioned  under  the  provisions  of  sections  47.56  and  4757,  R.  S.  (see  Navy 
Pension  Fund),  are  administered  by  the  Department  of  the  Interior.  Commis- 
sioner of  Pensions. 

2823.  The  laws  in  those  cases  involving  retirement  for  disability  resulting 
frum  an  incident  of  service  (sec.  1453,  R.  S.)  :  retirement  for  disability  not  an 
incident  of  service  (sec.  1454,  R.  S.)  ;  promotion,  disability  waived,  a  result  of 
wounds  incurred  in  the  line  of  duty  (sec.  1494.  R.  S.)  ;  retirement  in  next  higher 
grade  of  an  officer  failing  to  pass  physical  examination  on  account  of  disability 
contracted  in  line  of  duty  (sec.  1447,  R.  S.,  act  Mar.  4,  1911)  ;  not  to  be  retired 
for  misconduct  (sec.  14.56,  R.  S.,  act  Aug.  5,  1882)  ;  gratuity  payable  upon 
official  notification  of  death  fnsm  disease  or  wounds  originating  in  line  of  duty 
(act  May  13,  1908)  ;  and  gratuity  payable  upon  official  notification  of  death 
from  wounds  or  disease  not  a  result  of  own  misconduct  (act  of  Aug.  22, 
1912),  are  administered  by  the  Secretary  of  the  Navy.  Cases  of  officers  in- 
volving discharge  from  the  service,  retirement  or  promotion,  are  referred  to 
ihe  President  for  final  action. 

2824.  Medical  officers  are  required  to  enter  in  the  medical  records  of  all 
enlisted  men  or  officers  when  admitting  them  to  the  sick  list,  a  statement  as  to 
origin  of  the  disease  or  injury,  whether  in  the  line  of  duty  or  not  in  line  of 
duty.  These  records  eventually  are  filed  in  the  Bureau  of  ^ledicine  and  Sur 
gery,  where  they  are  cons^ulted  to  adjudicate  claims  for  pension  and  gratuity. 
Where  the  records  are  incomplete,  the  bureaxi  decides  whether  death,  injury, 
or  disability  occurred  in  the  line  of  duty.  (R.  4-564).  If  the  opinion  of  the 
medical  officer  admitting  the  patient  to  the  sick  list  is  adverse,  and  the  com- 
manding officer  does  not  concur,  evidence  in  rebuttal  will  be  entered  on  the 
health  record  and  the  medical  officer  will  proceed  in  the  manner  set  forth  in 
R.  2902,  copies  of  the  papers  being  forwarded  to  the  Bureau  of  Medicine  and 
Surgery  for  expression  of  opinion  and  then  to  the  department  for  final  action. 

The  same  method  should  be  followed  by  boards  of  medical  survey.  The 
•statement  of  evidence  in  rebuttal  should  be  incorporated  in  the  record  and 
referred  to  in  the  body  of  the  survey. 

The  senior  member  of  a  board  of  examination  for  promotion  or  for  retire- 
ment (R.  2902  (2) )  is  likewise  directed  to  inform  the  individual  concernetl  of 
the  adverse  entry  in  the  record. 

2825.  ^Yhen  a  medical  officer  makes  au  entry  in  the  record  of  an  officer 
indicating  the  use  by  that  officer  of  drugs  or  intoxicants  that  would  tend  to 
unfit  him  mentally,  morally,  or  physically  for  service,  he  shall  proceed  as  set 
forth  in  I  707   (5). 

2826.  The  purpo.se  of  the  entries  as  to  origin  of  disease  or  injury  in  relation 
to  "  duty  "  or  "  not  duty  "  being  for  administration  of  law,  it  is  of  the  utmost 
importance  that  medical  officers  should  with  their  opinion  make  a  clear  state- 
ment of  the  evidence  upon  which  the  opinion  is  based.  In  the  case  of  injury,  if 
the  man  was  not  actually  engaged  in  duty  at  the  time,  a  full  statement  should 
be  given  of  all  facts  upon  which  the  opinion  is  based.  In  the  case  of  disease, 
a  professional  opinion  with  due  regard  to  accepted  etiology  should  l)e  exjiressed. 


216        MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  V.    S.    NAVY. 

2827.  If  two  causes  nre  concerned  in  the  origin  of  a  disability,  one  a  pre- 
dlsposinp;  caiise  the  other  an  exciting  cause,  the  exciting  cause  will  warrant  the 
weight  of  favor. 

2828.  An  officer  on  the  retired  list,  unless  the  origin  of  the  disease  or  injury 
occurred  in  the  lino  of  duty  while  on  the  active  list,  is  not  entitled  to  the  bene- 
fits of  line  of  duty,  there  being  no  act  or  condition  of  duty  involved. 

2829.  If  a  patient  has  two  or  more  diseases  or  injuries  at  the  time  of  admis- 
sion, an  opinion  as  to  line  of  duty  shall  be  separately  recorded  for  each. 

2S30.  All  diseases  contracted  or  injuries  received  while  an  officer  or  en- 
listed man  is  on  active  duty  in  the  naval  service  of  the  United  States  may  be 
a.ssinned  to  have  occurred  in  line  of  duty,  unless  there  is  evidence,  first,  thai 
the  disease  or  injury  existed  prior  to  appointment  or  enlistment ;  second,  that 
it  was  contracted  while  absent  from  ship  or  duty,  on  leave,  over  leave,  or  absent 
without  leave ;  third,  that  it  occurred  in  consequence  of  willful  neglect  or  as  a 
result  of  his  own  misconduct. 

2831.  When  an  Individual  is  disabled  while  on  leave  or  in  confinement  the 
question  of  line  of  duty  must  be  determined  by  the  circumstances  attending  the 
incurrence  of  the  disability;  and  the  fact  of  being  on  leave,  and  if  in  confine- 
ment, whether  awaiting  trial,  or  in  accordance  with  sentence,  should  be  stated. 
In  cases  of  suicide  the  mental  condition  should  be  considered,  and  if  insanity 
exists  an  opinion  should  be  expressed  as  to  whether  or  not  the  insanity  was 
contracted  in  the  line  of  duty. 

The  following  letter  from  the  Secretary  of  the  Navy  to  the  Bureau  of  Medi- 
cine and  Surgery.  April.  1909,  will  govern  in  Navy  practice  so  far  as  relates  to 
injury  to  prisoners  resulting  fnmi  obedience  to  orders: 

"  Referring  to  your  letter  of  the  3d  instant,  requesting  a  decision  as  to 
whether  or  not  an  injury  received  by  a  prisoner  while  working  in  the  prison 
or  around  the  yard  is  to  be  considered  as  an  injury  received  in  the  line  of  duty, 
I  have  to  inform  you  that  prisoners  are  enlisted  men  in  the  Navy  or  Marine 
Corps,  and  that  work  done  by  them  in  the  j^rison  or  about  the  yard  is  performed 
in  obedience  to  orders  and  in  execution  of  military  discipline,  and  that  injury 
to  a  prisoner  resulting  from  obedience  to  such  orders  is  regarded  by  the  depart- 
ment as  in  line  of  duty,  as  it  would  be  in  the  case  of  other  enlisted  men,  not 
prisoners,  injured  in  the  execution  of  orders.  The  approval  of  a  sentence  of 
court-martial  does  not  impose  any  forfeiture  not  expressly  stated  in  the  sen- 
tence, or  which  may  by  statute  result  from  a  conviction." 

2882.  Injuries  occurring  during  athletic  sports  properly  indulged  in  or  in 
cf)nnection  with  physical  exercise  or  recreation  should  be  weighed  with  due 
regard  to  existing  regulations,  instructions,  and  orders.  A  recent  decision  reads 
as  follows :  "  The  policy  of  the  department  is  to  foster  athletics,  and  the  bureau 
considers  that  football  and  other  athletic  contests  of  enlisted  men  on  shore  are 
conducive  to  their  physical  development  and  well-being  and  better  fit  them  for 
the  performance  of  their  cUitics  on  board  ship,  and  that  injuries  received  In 
the.'?e  contests  may  be  justly  considered  in  the  line  of  duty."  (Horgan  case 
No.  4,^)8-5  of  .Tan.  3,  19(tS.) 

2H.'J3.  In  all  cases  where  the  opinion  not  in  line  of  duty  is  expressed  a  full 
statement  of  facts  should  be  given  irrespective  of  whether  evidence  In  rebuttal 
is  offered  at  the  time  or  not.  In  all  ca.ses  where  disability  is  incurred  in  the 
line  of  duty  and  the  treatment  iire.scrilied  is  declined,  that  fact  will  be  set  forth 
in  the  health  record  or  medical  survey. 

2834.  In  all  cases  of  death  not  in  the  line  of  duty  the  medical  ofhccr  should 
also  state  whether  in  his  opinion  the  death  was  a  result  of  the  individual's  own 
misconduct. 

2885.  A  midshipman  (hiring  his  course  at  the  Naval  Academy  incurring  In- 
jury or  disease  is  to  be  giveii  "line  of  duty"  or  "not  line  of  duty"  by  the 
medical  oflicer  preiiaring  the  records,  in  the  same  maimer  and  for  the  same 
causes  that  similar  entry  would  be  made  on  reports  to  the  bureau,  of  conunig- 
sioned  ofhcers  and  enlisted  men  of  the  Navy  and  Marine  Corps  (Navv  Depart- 
ment 5252-24,  May  2.".,  1900). 


MANUAL   FOR  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.         217 

2836.  The  status  of  midshipmen  with  relation  to  the  adjudication  of  a  claim 
foi'  pension  gratuity  is  determined  by  the  act  of  July  16,  1862.  (Ch.  183,  12 
Stat,  583,  sec.  1),  which  makes  nine  grades  of  the  active  list  of  line  officers  of 
the  Navy — rear  admiral,  first  grade;  midshipman,  ninth  grade.  (Baker  case, 
125  U.  Sl  R..  «46;  Cook  case,  128  U.  S.  R.,  254.) 

2837.  When  a  medical  officer  makes  entry  in  the  health  record  and  is,  after 
due  consideration  of  all  ascertainable  circumstances,  still  in  doubt  as  to  the 
origin  of  the  disease,  he  is  justified  in  saying  there  is  "  fair  "  or  "  some  "  evi- 
dence that  it  is  in  line  of  duty,  since  a  more  positive  statement  would  be  not 
only  misleadiiig  but  incorrect.  In  any  such  instance,  however,  he  should  be 
particularly  careful  to  enter  in  the  record  all  the  facts  upon  which  his  opinion 
is  based  in  order  that  they  may  be  available  for  consideration  by  a  board  of 
survey,  by  the  Bureau  of  Medicine  and  Surgery,  or  the  Pension  Bureau. 

If  a  medical  survey  is  held  in  such  a  case  the  "  onus  of  deciding  one  way  or 
the  other."  so  far  as'concerns  the  entries  on  the  report,  rests  entirely  with  the 
board.  While  the  facts  and  opinion  expressed  in  the  health  record  are  given 
due  weight,  the  decision  will  also  be  based  on  a  consideration  of  the  patient's 
statement,  the  subseouent  medical  records,  if  any,  and  such  additional  evidence 
as  may  be  available.'  That  the  board  should  reach  some  definite  conclusion  is 
important,  particularly  in  case  the  recommendation  is  for  discharge  from  the 
service,  and  if  a  unanimous  opinion  is  impracticable,  majority  and  minority 
reports  may  be  submitted,  when  the  final  decision  will  rest  with  the  bureau 
and  the  department. 

Section  4. — The  Practice  in  Adjudicating  Line  of  Duty  in  Keference  to 
Claims  for  Pension  and  Gratuity. 

2841.  Congress  has  enacted  laws  proffering  the  Government  gratuity  to  a 
beneficiary  of  a  deceased  officer  for  services  rendered.  The  spirit  inspiring  the 
gratuity  includes  the  intention  that  the  beneficiary  shall  have  all  the  assistance 
available  fi-om  the  Government  in  the  discovery  and  presentation  of  the  basic 
evidential  evidence  upon  which  his  claim  must  be  adjudicated.  It  is  not  a 
claim  growing  out  of  a  contractural  right ;  the  courts  have  held  it  to  be  merely 
a  gratuitv.  7 Letter  to  Secretary  of  the  Navy  from  Secretary  of  the  Interior, 
Jan.  9,  1913.) 

2842.  A  record  of  evidence  as  to  origin  of  disability  or  cause  of  death  is  re- 
quired by  section  6  of  the  act  of  July  4.  1864. 

2843.' When  a  statute  provides  pension  for  disability  or  death  occasioned  by 
wounds  or  injuries  received,  casually  occurring,  or  disease  contracted  in  the 
line  of  duty,  it  intends  that  the  performance  of  duty  must  have  relation  of 
causation  or  consociation,  mediate  or  immediate,  to  the  wound,  the  casualty, 
the  injury,  or  the  disease  which  produces  the  disability  or  death.  (Digest, 
Pension  Laws  and  Decisions,  etc.,  1881.) 

2844.  In  determining  the  right  of  favorable  opinion,  the  question  is  not 
whether,  when  the  cause  of  disability  or  death  occurred,  the  party  was  on  duty 
or  not,  in  active  service,  or  on  furlough,  or  leave,  in  arrest  or  not,  but  whether 
in  any  of  the  possible  conditions  of  service  the  cause  of  disability  or  death  was 
appurtenant  to,  dependent  upon,  or  connected  with  acts  within  or  acts  without 
the  line  of  duty.     (Digest,  Pension  Laws  and  Decision.s,  etc.,  1881.) 

2845.  Upon  the  question  of  casualty  the  opinions  of  experts  are  evidence, 
but  they  do  not  constitute  either  exclusive  or  conclu.sive  proof ;  and  the  question 
is  to  be  judged  on  the  facts  like  any  other  matter  of  evidence.  (Digest,  Pen- 
sion Laws  and  Decisions,  etc.,  1881. 

2846.  Death  or  injury  while  on  liberty,  incurred  in  the  act  of  attempting  to 
rescue  another  member  of  the  service,  is  regarded  as  line  of  duty  ;  such  death 
or  injury  incurred  attempting  to  save  civilians  is  not  in  line  of  duty. 


218        MANUAL    i;OK    THE    MEDICAL    UKl'AKTMENT,    U.    S.    SAW. 
Seciion  7. — Weight  or  Official  Recokd-s. 

2861.  Au  official  eoiUeun»oraneous  record  is  the  best  evidence,  as  to  facts 
tlierein  recited,  and  cfin  be  successfully  rebutted  only  by  direct,  positive,  and 
conclusive  evidence  showing  beyond  question  that  there  was  error  or  ""stake 
of  fact  or  fraud  in  making  said  record.     (7  P.  D.,  26 ;  2  P.  D.,  304 ;  4  P.  D..  114 ; 

2852."'  The  pension  act  of  March  3,  1885,  provides  that  applicants  for  pension 
shall  be  presumed  to  have  had  no  disability  at  the  time  of  enlistment,  and  such 
presumption  may  be  rebutted.  A  statement  In  a  certificate  of  discharge  that 
the  disabling  cause  existed  prior  to  enlistment  outweighs  and  rebuts  the  pre- 
sumption of  prior  soundness.     (1  P.  D.,  7;  12  P.  D.,  264.) 


CHAPTER  17. 


MEDIOAI.  AND  MATERIAL  SURVEYS  AND  TRANSFERS  OF  THE  SICK. 
Section  1.— Navy  Regvi.ations  Relating  to  Mkuicat.  Suhveys  on  Personnel. 

3901.  By  whom  requested  and  ordered.    R  361 ;  R  2960. 

2902.  Boards  of  survey,  how  constituted.     R  362. 

2903.  Reports   of   survey. 

(a)  Officers  and  enlisted  men  of  the  Navy.    R  363  (1). 

(6)   Officers  and  enlisted  men  of  the  Marine  Corps.    R  363  (2). 

2904.  Form  and  phraseology-  of  report  of  survey  .  R  .■'.64  (1). 

(a)  In  the  case  of  an  officer.    R  364  (2). 

(b)  In  the  case  of  an  enlisted  man.    R  364  (3). 

2905.  Cases  to  be  disposed  of  without  delay. 

(c)  Surveys  in  or  near  home  waters.    R  36.5  (1). 
(b)   Surveys  outside  home  waters.    R  365  (2). 

2906.  Surveys  in  the  United  States  on  enlisted  men  for  diseases  not  in  line 
of  duty.     R  366. 

2907.  Transportation  of  men  discharged  by  medical  survey.    R  3606  (6). 

2908.  Character  of  discharge  in  medical  survey.     R  3607  (3).      . 

2909.  Leave  and  extension  of  leave  on  account  of  sickness  requires  board  of 
survey.    R  3707  (1-4). 

2910.  .Joint  l)oard  of  survey  for  pen.sious.     R456t. 

Section  2. — Naval  Instructions  Ret.ating  to  Medical  Surveys. 

2911.  Sending  home  sick  condemned  by  survey.     1954  (2). 

2912.  Division  commander  to  order  and  act  upon  medical  surveys.  I 
1004  (1). 

2913.  Fleet  surgeon  to  approve  medical  surveys.     11122  (8). 

2914.  Officers  surveyed  in  hospital.     I  3221  (1-2). 

2915.  No  discharge  for  disability  except  by  survey.    I  3236  (1). 

2916.  Survevs  in  hospital  shall  name  ship  from  whiclx  patient  A\as  ad- 
mitted.    I  3236  (2).  ,.  y  ■  ^ 

Section  3. — Request  foe  Medic ae  Survey.     (Form  L.) 

2921.  A  single  copy  of  a  request  for  medical  survey  shall  J)e  made  uut  bj; 
the  medical  officer  of  a  ship  or  station  and  may  embrace  any  number  of  cases.  ^ 

2922.  If  in  the  fleet,  the  request,  after  approval  by  the  commanding  officer 
will  be  traiismitte<l  to  the  flagship,  and  upon  approval  by  the  irommander  in 
chief,  division  coinniander.  or  senior  officer  present,  a  board  will  be  designated 
upon  recommendation  by  the  fleet  surgeon  (or  division  surgeon). 

2923.  Requests  for  surveys  on  shore  stations  are  approved  anci  ordered  by 
the  commandant  of  the  station. 

2924.  Requests  for  medical  surveys  afloat  shall  be  made: 

(a)  When  in  the  case  of  an  officer  transfer  to  a  hospital  and  detachnieut 
from  the  ship  are  believed  advisable. 

219 


220        MANUAL   FOR    THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

(ft)  Wlieii  it  is  desirable  to  establish  the  origin  of  a  disability,  or  obtain 
an  opinion  as  to  the  nature  of  the  case,  or  to  determine  fitness  for  duty. 

(c)   When  transfer  to  a  distant  station  or  hospital  is  involved. 

2925.  Medical  surveys  are  not  required  for  a  transfer  to  a  near-by  naval 
hospital,  and,  as  a  rule,  afloat,  should  not  be  requested  for  the  purpose  of  in- 
validin.!^  from  the  service. 

202(».  When  a  hos])ital  ship  is  available  it  is  preferable  that  patients  re- 
quirinf^  hospital  treatment  or  sick  leave  should  be  transferred  to  the  hospital 
ship  for  treatment  and  further  disposition  Instead  of  being  surveyed.  Medical 
officei"S  on  ships  away  from  the  hospital  ship  shall  hold  their  patients  for 
transfer  to  the  hospital  ship,  except  in  those  cases  which  admit  of  no  delay. 

Section  4. — Report  of  Medical  Sukvey.     (Form  M.) 

2931.  Form  M  shall  be  made  out  in  duplicate  in  all  cases,  and  a  set  of 

reports  shall  be  for  one  case  only.  One  additional  copy  shall  be  furnished  for 
the  information  of  the  lleet  surgeon  (marked  "For  the  commander  in  chief"). 
In  the  case  of  a  marine  recommended  for  discharge  from  service  while  in  hos- 
pital, an  additional  copy  shall  be  prepared  and  forwarded  to  the  paymaster  of 
the  ivrarine  Corps. 

2932.  Reports  of  surveys  upon  officers  and  enlisted  men  of  the  Navy  will  be 
forwarded  direct  to  the  liureau  of  IVIedicine  and  Surgery  for  recommendation. 

2933.  One  copy  of  the  survey  is  forwarded  to  the  Bureau  of  Navigation  or 
Headquarters  U.  S.  M.  C,  and  one  copy  is  retained  in  the  record  and  pension 
division  of  the  Bureau  of  ISIedicine  and  Surgery. 

2934.  Upon  the  receijit  by  the  Bureau  of  Navigation  of  its  copy  of  the  sur- 
vey it  is  forwarded  to  the  officer  convening  the  board  for  compliance  with  the 
department's  action,  and  when  completed  it  is  returned  to  the  Bureau  of  Navi- 
gation to  be  placed  in  its  permanent  files. 

2935.  In  the  case  of  oflicers  and  men  of  the  ^Marine  Corps  tlie  copy  follows 
the  same  course,  except  that  it  goes  to  the  Commandiint  of  the  Marine  Cori)s 
instead  of  to  the  Bureau  of  Navigation. 

2936.  The  following  i)aragriiphs  on  the  face  of  the  report  shall  be  carefully 
and  accurately  filled  out: 

(a)  Diagnosis — Shall  be  selected  from  the  Navy  nomenclature  and  .should 
correspond  with  that  under  which  the  man  is  carried  on  the  sick  list.  In  the 
case  of  injury  a  key  letter  shall  be  supi»liod. 

(b)  Origin — It  is  the  board's  duty  to  state  clearly  whether  or  not  they  con- 
sider the  origin  in  or  not  in  line  of  duty,  also  whether  it  is  considered  that  the 
disability  is  or  is  not  the  result  of  his  own  misconduct. 

(c)  Facts — All  facts  relative  to  the  present  history  of  the  case  should  be 
clearly  stated. 

{(l)  Pre.sent  condition — "Unfit  for  duty"  means  temporary  unfitness;  "  unlir 
for  service  "  means  permanent  unfitness.  If  the  patient  is  found  fit  for  duty  the 
report  shall  be  concluded  at  this  point. 

(e)  l'rol)able  future  duration.  When  unfitness  is  found  and  is  regarded  as 
temporary,  tlie  phrase  "  temporary  "  shall  be  used.  When  the  unfitness  is  per- 
manent the  expression  "  ii(>rmanent  "  shall  be  employed. 

(/)  Heconunendation.  Under  this  head  shnll  be  given  the  contemplate<l  dis- 
position of  the  patient.  In  the  case  of  an  ollicer  the  reconunendation  may  be 
detachment  with  sick  leave;  or  if  the  unfitness  is  temporary  the  odicer  may  be 
recommende<l  for  hospital  treatment,  with  a  view  to  Ids  return  to  the  shii»  or 
station.  If  the  disability  is  considered  i)erman(Mit  the  board  shall  reconnuend 
that  he  be  ordered  before  a  retiring  board.  Fnlisted  men  shall  be  reconnnende<l 
f(n*  hospital  treatment,  observation,  etc.,  or  for  discharge  from  the  naval  service, 
or  from  the  Marine  Corps  In  the  case  of  a  marine. 

(jj)  The  recommendation  that  an  ofliivr  be  orderetl  before  u  retiring  board, 
or  that  an  enlisted  man  be  iuvaiideil  from  the  service  shouUl  not  ordinarily  he 
made  until  the  case  has  been  siifliciently  long  under  observation  to  render  the 


MANUAL    FOR    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.  221 

exact  nature  and  degree  of  the  disability  and  its  prol>able  permanency  evident, 
and  as  a  rule  such  recommendation  shall  not  be  made  until  the  case  has  been 
under  a  period  of  observation  at  a  naval  hospital.  Before  recommending  the 
invaliding  of  a  continuous-service  man  from  the  service  the  board  should  care- 
fully consider  the  probability  of  his  recovery  under  extended  treatment,  espe- 
cially when  the  disability  is  in  line  of  duty.  In  the  case  of  recruits  retention 
for  prolonged  treatment  when  a  restoration  to  duty  is  unlikely  is  undesirable. 

(h)  In  any  case  where  the  reconnuendation  involves  invaliding  from  the 
service  for  a  mental  infirmity  the  board  shall  state  that  such  a  disposition  will 
not  constitute  a  menace  to  the  individual  surveyed  or  to  the  public  safety. 
When  the  case  is  of  an  infectious  nature  or  of  a  chronic  or  disabling  nature  a 
statement  should  also  be  made  that  if  the  case  is  invalided  from  the  service  it  Is 
unlikely  ti>  constitute  an  unusual  menace  to  the  public  health  or  to  become  a 
public  charge. 

(i)  The  hoard  shall  be  careful  to  state  definitely  its  opinion  as  to  the  origin 
of  the  disease  or  injury,  giving  all  the  facts  and  circumstances  connected  with 
the  disease  or  injury,  and  whether  associated  with  the  performance  of  duty  or 
whether  the  exposure  was  incident  to  any  act  of  the  service.  In  the  case  of  an 
enlisted  man  a  statement  will  be  made  of  the  board's  opinion  as  to  whether  the 
disease  or  injury  is  or  is  not  due  to  the  misconduct  of  the  enlistefl  man  who  is 
the  sul)ject  of  the  survey.  The  statement  of  the  patient  in  connection  with 
origin  of  the  disease  or  disability  must  be  weighed  by  rules  governing  evidence 
in  general  and  shall  be  accepted  or  rejected.  The  provisions  of  article  R  2902 
(1-4)  regarding  "  not  in  line  of  duty  "  lindiugs  shall  be  carefully  complied  with 
by  all  boards  if  medical  survey,  and  the  facts  stated  on  the  report. 

2937.  When  surveys  are  held  upon  enlisted  men  at  ho.spitals  the  board  .shall 
be  careful  to  state  on  the  report  the  names  of  the  ships  from  which  the  men 
were  received. 

Section  5. — General  Information  Regarding  Surveys  on  the  Personnel. 

2941.  In  all  cases  of  medical  survey  held  on  board  ship,  at  navy  yards  and 
naval  stations  the  medical  officer  requesting  a  survey  shall  cause  a  full  entry  of 
the  report  of  the  board  to  be  entered  in  the  health  record.  No  person  shall  be 
surveyed  before  being  fully  admitted  to  the  sick  list. 

2912.  In  surveys  held  at  hospitals  the  board  shall  be  careful  to  specify  in 
the  report  the  name  of  the  vessel  from  which  the  patient  was  received. 

2943.  Enlisted  men  condemned  by  survey  on  foreign  stations  who  are  recom- 
mended for  discharge  from  the  service  will  be  sent  to  a  receiving  ship  and  not 
to  a  naval  hospital  for  final  action,  unless  requiring  hospital  treatment,  and 
such  disposition  shall  be  specifically  recommended  by  the  board. 

2944.  The  expenses  connected  with  the  transportation  of  sick  enlisted  men 
of  the  Navy  and  Marine  Corps  to  naval  hospitals  are  a  charge  against  appro- 
priations under  the  control  of  the  Bureau  of  Navigation  and  the  Marine  Corps, 
respectively. 

2945.  Medical  surveys  of  officers  and  enlisted  men  of  the  Navy,  when  acted 
upon  by  the  officer  convening  the  board,  are  forwarded  in  duplicate  direct  to  the 
Bureau  of  I\Iedicine  and  Surgery  for  recommendation  by  the  Surgeon  General 
and  transmission  to  the  Bureau  of  Navigation  for  final  action.  One  copy  of  the 
report  is  retained  for  the  files  of  the  Bureau  of  Medicine  and  Surgery ;  the 
other  is  forwarded  to  the  Bureau  of  Navigation.  The  latter  copy  is  sent  bv 
that  bureau  to  the  officer  ordering  the  survey  for  his  information  and  compli- 
ance. It  is  then  returned  by  him  to  the  Bureau  of  Navigation  for  its  permanent 
files.  At  training  stations  and  on  receiving  ships  the  cases  of  recruits  who  are 
surveyed  by  boards  of  medical  survey  will  be  acted  upon  by  the  senior  officer 
present.  Wlien  a  board  of  survey  is  ordered  upon  recruits  the  senior  member 
Avill  be  preferably  an  officer  of  experience,  with  a  full  knowledge  of  service  con- 
ditions. All  such  surveys  with  report  of  action  are  sent  to  the  Bureau  of  Medi- 
cine and  Surgery  for  further  transmission  to  the  Bureau  of  Navigation. 


222         MAM  UAL    FOH    THK    MEDICAI.    DEPARTMENT,    U.    S.    JSIAVY. 

2946.  Medical  surveys  upon  officers  and  men  of  the  Murine  Corps  take  tlie 
same  course  after  action  by  the  officer  convening  the  board,  except  that  "  Com- 
luandant  of  the  IMariue  Corps  "  is  substitutwl  for  "  liureau  of  Navigation"  in 
Ihe  preceding  paragraph. 

2947.  Before  a  general  court-marti:il  i)risoner  is  transferred  to  a  disciplinary 
ship  a  board  of  niedi(  al  survey  of  three  medical  officers  shall  be  orderetl  to  de- 
termine the  prisoner's  physical  fitness  for  the  service.  In  any  case  of  physi<?al 
unfitness  a  report  will  be  made  to  the  department  (office  of  the  Judge  Advocate 
General).  (Department  letter  No.  26267-81  of  Dec.  12.  1912;  Medicine  and 
Surgerv  letter  No.  125439.)      (See  also  Par.  2115.) 

2948.  (ft)  Medical  officers,  particularly  those  in  connnand  of  naval  hos- 
pitals, will  request  surveys  without  undue  delay  in  the  case  of  all  oflicers  or 
enli.sted  men  who  are  cousidei-ed  physically  unfit  for  further  active  service,  with 
a  view  to  final  action  in  such  ca.ses,  so  that  their  places  can  be  filled  in  the  fleet 
and  elsewhere. 

(&)  A  person  under  treatment  in  a  hospital  for  a  period  of  three  months 
shall  be  surveyed  in  ord(M-  that  his  further  treatment  or  other  disposition  may 
be  authorized,  and  in  ordei-  that  the  bureau  may  have  information  as  to  the 
necessity  for  such  prolonged  treatment. 

(c)  Care  shoidd  be  taken  that  all  convalescents  are  promptly  returned  to 
duty. 

Skction  6. — Navai.  Inktkuctions  Uki.ating  to  Surveys  oa  Matkbial. 

2951.  Surgical  appliances  only  replaceable  after  survey.     1212*.^. 

2952.  Loss  or  destruction  of  stores  necessitates  survey.     I  212.S. 
295.3.   Death  of  officer  in  charge  of  supplies.    I  4421  (4). 

2954,  Survey  of  unserviceable  and  i?isanitary  articles.  I  lllol;  I  4750; 
I  478.-)  ( 1 ) . 

2955.  Surveys  on  medical  stores,  by  whom  ordered.     I  4<41»  (1). 
(n)  Articles  expendable  without  survey.    14749  (2). 

(b)  Surveys  at  medical  supply  depots.    I  4749  (3). 

(c)  Keports  of  survey  forwarded  in  duplicate.    I  4749  (4). 

{(I)  Articles  to  be  sold  nuist  be  appraised  and  inventoried.    I  4749  (5). 
(e)   Articles  to  general  storekeeper  to  be  invoiced  as  to  value.    I  4749  (6). 
295(i.  Clothing  and   personal  effects  to  be  destroyed   to  prevent   spread  at 
disease.     I  4750  (1). 

Section  7, — Blank  Forms  kor  Survky  of  Matekiat..     (Forms  C  and  O-l, 

Ca  and  Ca-1.) 

2961.  Forms  C  and  C-1,  Ca  and  Ca-1  shall  be  u.sed  in  surveys  upon  all  meiH- 
cal  and  surgical  supplies  and  materials  and  forwarded  in  duplicate. 

2962.  Medical  officers  will  not  be  released  from  responsibility  for  the  loss  or 
destruction  of  pn.jiertv  in  the  Medical  Department  unless  the  expenditure  Is 
authorized  bv  the  bureau  or  by  a  board  of  survey.     (I  2122;  I  2123;  I  4749  (2.) 

29(53.  Forms  C  and  C-1  shall  be  used  in  all  surveys  upon  property  at  naval 
niedi<-al  supplv  depots,  and  Forms  Ca  and  Ca-1  elsewhere. 

2964.  All  articles  surv(\ved  shall  bo  entered  on  Form  Ca-1,  following  the 
order  and  nomenclature  of  the  supply  table. 

2966.  Articles  recommeiide<l  for  survey  shall  be  disposed  of  under  one  of 
th<'  following  subcolnmns,  the  number  of  articles  to  be  indicated  by  figures,  viz: 

(«)   Fit  t<ir  use. 

ih)    Fit  lor  use  when  rei)aire(l  on  the  ship  or  station. 

(c)  To  medical  stipply  depot. 

(d)  To  geni'ral  str)rokeeper  for  final  di.spositlon. 
le)   T^estroy,  being  of  no  value. 

2966.  ArliVles  cMitlrely  useless  and  valueless,  or  which  are  prejnilicitd^to^ 
the  health  of  the  ship's  compsiny.  shall  be  entered  under  colunuj  Vllle.  (I  1351;* 
I  4735;  T  4750.) 


AlANUAL  i-Oi;    THE   MEDICAL   DEPARTMENT,   U,    S.    NAVY.         223 

2967.  Whenever  surveyed  articles  are  sent  to  a  supply  depot  they  shall  be 
accompanied  by  duplicate  invoices,  on  vphich  will  be  noted  dates  of  survey  and 
disposition  recommended  as  to  articles  invoiced. 

2968.  Surveys  on  articles  on  board  ships  and  at  stations  and  hospitals  may 
be  held  whenever  necessary. 

2969.  At  medical  supply  depots  surveys  shall  be  held  on  all  returned  stores 
from  ships  and  stations,  and  upon  such  stores  as  are  broken  and  unaccounted 
for,  or  which  have  undergone  deterioration. 

2972.  Surveys  \ipon  medical  property  may  be  ordered  by  the  commander  in 
chief,  division  commander,  or  the  senior  officer  present.     (I  4749.) 

2973.  All  articles  on  the  supply  table  of  the  Medical  Department  and  indi- 
cated as  nonexpendable  that  have  become  unfit  for  use  shall  be  surveyed  before 
the  issue  of  others  to  replace  them. 

2974.  A  survey  shall  be  held  at  each  medical  supply  depot  on  all  medical 
supplies  considered  unfit  for  u.se  turned  in  from  cruising  ships  placed  out  of 
commission.  Such  articles  as  are  found  fit  for  use  shall  be  turned  into  the 
general  stock  for  issue. 

2975.  Whenever  any  property  belonging  to  the  Medical  Department  is  sur- 
veyed and  recommended  to  be  sold  the  articles  shall  in  all  cases  be  appraised. 
The  medical  officer  in  charge  shall  make  an  inventory  of  the  same,  and  shall 
carefully  preserve  the  property  until  directed  to  deliver  it  for  sale.  A  copy  of 
this  inventory  shall  be  forwarded  to  the  Bureau  of  Medicine  and  Surgery  as 
soon  as  the  report  of  survey  is  approved.     (I  4749  (5).) 

2976.  Supplies  delivered  to  a  general  storekeeper  for  sale  shall  be  accom- 
panied by  an  invoice  stating  both  the  original  and  appraised  value  of  the 
articles.     (I  4749  (6).) 

2977.  Reports  of  survey  on  property  belonging  to  the  Medical  Department 
shall  be  forwarded  in  duplicate.  From  ships  in  the  fleet  such  reports  shall  be 
forwarded  through  the  commander  in  chief  and  receive  the  indorsement  of  the 
rteet  surgeon. 

2978.  After  approval  the  original  of  the  survey  is  filed  in  the  bureau  and 
the  duplicate  copy  returned  to  the  medical  officer  reqiiesting  the  survey  for 
compliance  and  for  the  tiles  of  the  medical  department  of  the  ship  or  station. 

Section  8. — Navy  Regiilations  and  Naval  Instructions  Governing  Transfers. 

2981.  Serious  cases  transferred  to  hospital  to  be  accompanied  by  medical 
officer  if  practicable.    R  2961  (1). 

2982.  Patients  transferred  to  have  hospital  ticket  and  health  record  accom- 
panying.   R  2961  (2). 

2983.  Phvsical  examination  required  before  transfer  of  enlisted  men.  (R 
3581  (5)  ;  R  2961  (3).) 

2984.  Papers  to  be  transmitted  upon  transfer.     R  3-585. 

2985.  Patients  transferred  to  ho.spitals  not  United  States  naval  hospitals. 
R  2962  (1-4). 

2986.  Patients  transferred  or  received  to  be  reported  to  fleet  surgeon  if  in 
foreign  port,  and  to  the  Bureau  of  Medicine  and  Surgery  if  in  a  United  States 
port.    R  2962  (5). 

2987.  Transfer  of  tuberculosis  cases.     R  3582  (2). 

2988.  Allotments  on  transfer  to  hospital.     R  4475. 

2989.  Accounts  of  enlisted  men  transferred  to  be  accoinp;inie<^i  by  certificate 
of  medical  officer.    I  4890  (6). 

2990.  Transfer  of  marines.    I  3551  (3). 

2991.  Care  of  effects  of  disabled  persons  transferred.     I  718. 

'  2998.  Entries   to  be  made  in   service  and   health   records   on   transfer.     I 
3208  (2). 

2993.  Health  records  to  accompany  officers  and  men  upon  transfer.    132-57. 


224        MANUAL   FOR    THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

Section  9. — General  Directions  Relating  to  the  Transfer  of  the  Sick  and 

Disabled. 

3001.  Upon  the  recommendation  of  the  medical  officer  of  a  sliip  or  station  or 
as  tlic  result  of  the  reconnnendation  of  a  hoard  of  medical  survey,  sick  persons 
may  be  transferred  to  a  naval  hospital  at  smy  time  with  Uie  approval  ol  the 
conmiandant  or  senior  officer  present.     (U  3582  (1).) 

3002.  The  accounts  and  other  papers  of  enlisted  men  of  the  Navy  and  Marine 
Corps  transferred  to  any  other  than  a  naval  hospital  are  retained  on  board 
until  the  ship  leaves  the  port  in  which  the  hospital  is  located.  Patients  left 
behind  in  the  liospital  shall  be  furnished  with  their  accounts  and  copies  of  their 
service  records,  the  oritiinal  of  the  service  record  being  forwar<led  to  the  Bureau 
of  Navigation.     (R  3582  (4).) 

3003.  Patients  tran.sferred  to  any  other  than  a  naval  hospital  and  remain- 
ing there  after  the  departure  of  the  ship  to  which  they  were  attached,  shall, 
upon  their  recovery,  report,  preferably  by  telegraph,  to  the  Bureau  of  Naviga- 
tion for  further  instructions.  The  surgeon  in  charge  of  the  hospital  shall  be 
requested  to  furnish  them  with  certificates,  giving  the  dates  of  their  admission 
to  and  their  discharge  from  the  hospital. 

3004.  The  pay  of  an  enlistetl  man  of  the  Navy  or  Marine  Corps,  when  under 
treatment  in  a  United  States  naval  hospital,  ceases  when  his  term  of  enlistment 
expires,  but  he  may  be  retained  in  the  hospital  for  further  treatment.  When 
under  treatment  in  a  hospital  on  a  foreign  station,  his  pay  continues  until  he  is 
regularly  di-scharged  from  the  service,  even  after  his  term  of  enlistment  has 
expired.  In  accordance  with  a  decision  of  the  department  the  provisions  af 
article  R  3669  (5)  may  be  so  construed  as  to  leave  to  the  discretion  of  an  officer 
in  conmiand  of  a  ho.spital  wliether  or  not  any  money  and  the  amount  thereof, 
should  be  paid  to  an  enlisted  man  under  treatment  at  a  hospital. 

3005.  Patients  transferred  to  the  naval  hospital,  Philadelphia,  for  treat- 
ment should  1)0  directed  to  report  to  the  governor  of  the  Naval  Home. 

3007.  Whenever  it  becomes  necessary  to  send  sick  and  disabled  officers  and 
enlisted  men  of  the  Navy  or  Marine  Corps  home  in  a  supply  or  chartered  sliip, 
the  commander  in  chief  may  order  a  board  of  ofhcers,  one  of  whom  shall  be 
an  experienced  lyedical  oflicer,  to  examine  the  ship  and  report  to  him  in  writing 
whether  such  vessel  is  suitable  for  the  purpose  and  whether  everything  neces- 
sary has  been  provided  for  their  health  and  comfort.  He  .shall  not  permit  the 
departure  of  a  slilp  until  satisfied  that  every  possible  provision  that  jnay  be 
deemed  necessary  has  been  made  for  the  comfort  of  the  sick,  and,  if  necessary, 
he  shall  detail  a  suitable  number  of  extra  medical  officers  to  accompany  such 
ship.     (I  953.) 

3008.  All  sick  and  disabled  officers  and  men  shall,  if  practicable,  be  sent 
home  in  public  vi-ssels  and  only  in  cases  of  urgent  necessity  shall  vessels  be 
chartered  for  this  i)urpose.      (I  954.) 

3009.  Tlie  commander  in  chief  may,  at  his  discretion,  send  home  by  other 
conveyance  patients  surveyed  and  condemned  by  a  board  of  medical  officers 
whose  condition  is  such  as  to  render  it  necessary  to  avoid  climatic  inlluences, 
delay,  or  other  influeiK-e  alTecting  their  health  to  which  they  would  be  sub- 
jected in  a  public  slii]».      (I  9.54   (2).) 

3010.  The  exi)enses  connected  with  the  transfer  or  transportation  of  sick 
enlisted  men  are  defrayed  from  appropriations  under  the  control  of  the  Bureau 
of  Navigation. 

3011.  The  treatment  in  naval  hospitals  of  officers  and  men  of  the  Naxal 
auxiliary  service  was  approved  by  the  department  on  June  15,  ]9t)8,  and 
authorized  by  the  Bureau  of  Medicine  and  Surgery  in  circular  letter  of  .Tune 
24,  1908.  (M.  and  S.  No.  11.53;«).)  The  Treasiu-y  Department  in  Departftiontal 
Circular  No.  23,  of  May  1.3.  1909,  authorized  the  care  and  tn>atmerit  of  officers 
and  enlisted  men  of  the  Army  and  Navy  and  civilian  officers  and  crews  of 
naval  auxiliaries  in  hospitals  of  the  Public  Ibviltli  Service  ui>on  the  written 
refiuest   of  their  respective  connnanding  oinc«'rs. 


MANUAL   FOR   THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY.  225 

3012.  An  officer  or  man  actually  employed  in  the  naval  auxiliary  service 
who  is  ahsent  from  his  duty  for  treatment  in  a  hospital,  or  on  board  a  hospital 
ship  or  other  naval  vessel,  shall  while  so  absent  from  duty  receive  half  pay, 
excluding  the  day  of  admission  and  including  the  day  of  discharge,  except 
where  such  absence  is  due  to  venereal  disease  of  the  officer  or  man,  in  which 
case  he  shall  receive  no  pay  while  so  absent.  (Changes  in  Reg.  for  N  A  S 
1914,  No.  13,  par.  95.) 

3013.  Notations  will  be  made  on  ration  notices  whenever  officers  and  men 
of  the  naval  auxiliary  service  are  admitted  to  hospital  as  to  whether  or  not  for 
venereal  disease,  and.  further,  should  changes  be  made  in  diagnosis  involving 
discharges  from  or  admissions  as  cases  of  venereal  disease,  subsequent  appro- 
priate ration  notices  of  discharge  or  admission  will  be  issued. 

98601°— 17 15 


CHAPTER  18. 


THE  INSANE  OF  THE  NAVY. 

Section  1.— Laws  Relating  to  the  Establishment  and  Administration  of 
St.  Elizabeths  Hospital  and  Regulations  Relating  to  the  Insane. 

3101.  Insane  of  the  Navy;   authority   of  the  Secretary  of  the  Navy,  etc. 

Sec.  1551,  R.  S.  ,      T  c        4000 

3102.  Estal)Iishment  of  St.  Elizabeths  Hospital  tor  the  In.sane.     Sec.  48d>>, 

R.  S. 

3103.  The  superintendent.     Sec.  4839,  R.  S. 

3104.  Boaril  of  visitors.     Sec.  4840,  R.  S. 

3105.  President  of  board  of  visitors.    Sec.  4841,  R.  S.  ;, 

3106.  Powers  and  duties  of  tlie  board  of  visitors.     Sec.  4842,  R.  b.  ,„ 

3107.  Admission  of  insane  persons  of  the  Army,  Navy,  and  ^Marine  Corps, 
etc.     Sec.  4843,  R.  S. ;  act  Mar.  3,  1875. 

3108.  Limit  to  admission.     Act  June  16,   1880. 

3109.  Transfer  of  insane  convicts,  etc.,  to  St.  Elizabeths  Hospital.     Sec.  48.j_, 
'  R.  S. ;  acts  Juno  23,  1874,  Aug.  7,  1882.  ^.     .,,.-,      . 

3110.  Admission  of  insane  from  National  Home  for  Disabled  Volunteers. 
Act  Aug.  7,  1882.  .        ^  ^,  ,       ,  .        ., 

3111.  Admission  to  Hospital  for  In.sane  in  the  District  of  Columbia,  hecs. 
4843-4854,  R.  S. :  acts  June  23,  1874,  Mar.  3,  1S75,  Mar.  3,  1879,  Aug.  7,  18S2, 
Julv  7,  1884,  Jan.  31,  1899.  ,      ^, 

3112.  Enlistment  of  insane  persons  prohibited.  (Articles  lor  the  Orovorn- 
nient  of  the  Navy.)  R.  19. 

Section  2.— General  Directions  Regarding  the  Insane  of  the  Navy. 

3121.  The  Secretary  of  the  Navy  is  authorized  by  law  to  make  suitable 
provision  for  the  care  of  the  insane  of  the  Navy  by  plaging  them  in  St.  Eliza- 
beths Hospital  in  the  District  of  Columbia  or  in  any  other  institution  devoted 
to  the  care,  maintenance,  and  support  of  insane  persons. 

3122.  Under  the  provisions  of  the  law  relating  to  the  care  of  the  insane  ot 
the  Navy  the  following  classes  of  persons  are  entitled  to  treatment  in  St. 
Elizabeths  Hospital. 

(a)  Insane  men  belonging  to  the  Navy  and  Marine  Corps. 

(b)  Men  who  while  in  the  service  of  the  United  States  in  the  Navy  or 
Marine  Corps  have  been  admitted  to  the  hospital  and  thereafter  discharged 
from  the  hospital  on  the  supposition  that  their  reason  was  restored  and  withiu 
three  years  after  such  discharge  have  again  become  insane  from  causes  existing 
at  the' time  of  such  discharge  and  who  have  no  adequate  means  of  support. 

(c)  Indigent  insane  persons  who  have  served  in  the  Navy  or  Marine  Corps 
and  have  been  discharged  therefrom  on  account  of  disability  arising  from 
such  insanity.  .  ..,  .      ^, 

id)  Indigent  insane  persons  who  have  become  insane  within  three  years 
after  their  discharge  from  the  Navy  or  Marine  Corps  from  causes  \yhich  aros^ 
during  and  were  produced  by  said  service. 

(e)  Women  patients  admitted  to  St.  Elizabeths  Hospital  are  limited  to 
those  residing  in  the  District  of  Columbia,  who  are  wives  and  widOAVs  of  naval 
officers  and  enlisted  men.     (M.  and  S.  120642.) 


228        MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

3123.  Indigent  or  insane  persons  who  liave  been  discharged  from  fhe  Navy 
or  Marine  Corps  must  show,  in  order  to  gain  admission  or  readmission  to  St. 
Eii/.ahetlis  Hospital,  that  their  disability  was  incurred  in  or  was  connected  with 
their  service  in  the  Navy  or  Marine  Corps. 

3124.  To  relieve  the  Goveninient  of  the  care  of  niontal  defectives  whose 
disabiilty  may  have  had  its  origin  prior  to  enlistment,  medical  oflicers  on  duty 
where  recruits  are  assembled  should  carelully  observe  all  recruits  for  stigmata 
of  degeneration,  vicious  habits,  and  mental  almormalities.  Recruits  suspected 
of  mental  instal>ility  sliould  be  made  the  subject  of  special  inquiry,  and  if  the 
evidence  of  unfitness  for  active  service  al)oard  ship  is  forthcoming,  such  in- 
dividuals may  be  brought  to  the  notice  of  the  commanding  oflicer  as  undesirable 
and  discharged  or  surveyed  and  returned,  if  practicable,  to  the  next  of  kin  or 
place  of  enlistnient.     (M.  and  S.  Memo.  121591,  Dec.  14,  1910.) 

3125.  Boards  of  medical  survey  concerned  with  recommending  the  transfer 
of  insane  to  hospital,  should  consider  the  practicability  in  each  individual  case 
of  having  the  patient  transferred  under  the  charge  of  a  responsible  chief  phar- 
macist's mate,  with  attendants,  if  necessary.  (M.  and  S.  Memo.  12.5012,  June 
28,  1912.) 

3126.  Whenever  practicable  patients  giving  evidence  of  being  insane  shall 
be  transferred  to  a  naval  hospital  at  which  a  psychopathic  ward  has  been  estab- 
lished for  treatment  and  observation  prior  to  medical  survey  and  final  deter- 
mination of  their  mental  condition  and  commitment  to  a  hospital  for  the  insane. 

3127.  Medical  officers  having  charge  of  an  insane  patient  prior  to  recom- 
mending transfer  to  a  hospital  for  the  insane  shall  endeavor  to  obtain  an 
accurate  family  and  personal  history  of  the  patient  and  to  secure  statements 
relative  to  the'  case  from  any  institution  for  the  insane  of  which  the  patient 
may  have  been  an  inmate.  Any  such  statement  should  be  appended  to  the 
report  of  medical  survey. 

3128.  No  officer,  .seaman,  or  marine  shall  be  admitted  as  a  patient  into  a 
hospital  devoted  to  the  care  of  the  insane  of  the  Navy  until  he  shall  have  been 
condemned  by  a  board  of  naval  medical  officers  and  the  report  of  the  board  has 
been  approved  by  the  department. 

3129.  Upon  the  approval  by  the  department  of  the  report  of  medical  survey, 
the  Bureau  of  Medicine  and  Surgery  will  forward  through  official  chaimels  to 
the  hospital,  station,  or  ship,  or  wherever  the  patient  may  be,  an  order  for  his 
admission  to  St.  Elizabeths  Hospital,  and  an  Interior  Department  form  to  be 

filled  out. 

3130.  Medical  officers  shall  exercise  great  care  in  preparing  the  Interior 
Department  form,  giving  as  full  a  medical  history  in  each  case  as  possible. 

3131.  On  the  1st  of  .Tuly  of  each  year  the  Superintendent  of  St.  Elizabeths 
Hospital  forwards  to  the  Bureau  of  IMedicine  and  Surgery  a  report  for  the  year 
ended,  showing  the  condition  of  the  insane  of  the  Navy  and  Marine  Corps  under 
treatment,  together  with  the  number  admitted,  discharged,  died,  and  remaining 
uixler  treatment. 

3132.  Upon  the  recovery  of  an  officer  or  enlisted  man  of  the  Navy  or  IVIarine 
Corps  under  treatment  in  a  hospital  for  the  insane,  the  department  is  notified 
of  the  fact  by  the  superintendent  in  charge  of  the  hospital,  and  the  Bureau  of 
Navigation  or  Headquarters  of  the  Marine  Corps  directs  his  transfer.  A  medi- 
cal survey  is  then  ordered  to  determine  the  disposition  of  the  patient.  Tlie 
ijureau  of  Medicine  and  Surgery  is  notified  of  discharges  in  all  su<-h  ca.ses. 

3133.  In  tlie  transjjortation  of  the  insane,  suitable  nn'asures  shall  be  taken 
to  insure  their  proper  care  and  treatment  while  in  transit. 

3!34.  rpMM  tlie  .'Mliuission  of  a  patient  into  St.  Elizabeths  Hospital  the 
hospital  authorities  furnish  the  medical  officer  detailed  for  such  duty  with  a 
receipt  for  the  person  and  the  personal  elTtnts  of  the  iiatient.  The  receipt  shall 
be  forwarded  withovit  delay  to  the  Bureau  of  Medicine  and  Surgery  for  the 
permanent  files  of  the  bureau. 

3135.  The  receli)t  l>y  the  bureau  of  the  certificate  relating  to  the  admission 
of  the  patient  is  a  necessary  i»rellnnnary   to  the  Indorsement  by  the  Surgeon 


MANUAL   FOR   THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY.         229 

General  on  the  orders  of  the  medical  officer  that  his  duties,  so  far  as  they  per- 
tain to  the  Bureau  of  Medicine  and  Surgery,  have  been  completed. 

3136.  The  superintendent  of  St.  Elizabeths  Hospital  informs  the  Bureau  of 
Medicine  and  Surgery,  as  soon  as  practicable  after  its  occurrence,  of  the  death 
of  every  officer  or  enlisted  man  of  the  Navy  or  Marine  Corps  who  dies  while 
under  treatment  in  this  institution.  The  official  death  report  shall  be  prepared 
and  signed  by  the  medical  officer  assigned  to  duty  in  connection  with  the 
patients  from  the  Navy  and  Marine  Corps  in  St.  Elizabeths  Hospital.  In  case 
no  medical  officer  is  so  assigned  the  death  report  will  be  prepared  in  the  Bureau 
of  Medicine  and  Surgery. 

3137.  For  the  information  of  the  superintendent  of  St.  Elizabeths  Hospital 
the  following  records  shall  accompany  each  patient  upon  his  admission  to  the 
hospital : 

(a)  Order  for  admission. 

(b)  Copy  of  medical  survey. 

(c)  Copy  of  hospital  ticket, 

(d)  Health  record,  with  a  request  that  a  concise  record  of  the  case  be  con- 
tinued therein,  and  the  record  forwarded  with  the  patient  In  case  of  transfer, 
or  in  case  of  death,  desertion,  or  termination  of  service  to  be  forwarded  to  the 
Bureau  of  Medicine  and  Surgery. 

(e)  Copy  of  Department  of  Interior  form.      (Procurable  from  bureau.) 

Section  3. — Laws  Relating  to  the  Care  of  Insane  Patients  on  the  Pacific 

Coast. 

3141.  Care,  maintenance,  and  treatment  of  the  insane  of  the  Navy  and 
Marine  Corps  on  the  Pacific  coast.     (Annual  naval  appropriation  act.) 

Section  4. — Instructions  Relating  to  the  Admission   of  Patients  to  the 
State  Hospitals,  California. 

3151.  A  clause  in  the  annual  naval  appropriation  act  makes  suitable  pro- 
vision for  the  care,  maintenance,  and  treatment  of  the  insane  of  the  Navy 
and  Marine  Corps  on  the  Pacific  coast. 

3152.  Under  an  annual  contract,  commencing  with  each  fi.scal  year,  and 
entered  into  between  the  California  State  Conmiission  of  Lunacy  and  the 
Secretary  of  the  Navy,  the  insane  of  the  Navy  and  Marine  Corps  on  the  Pacific 
coast  are  sent  for  treatment  to  a  State  hospital  for  the  insane. 

3153.  On  the  1st  day  of  .January  and  .July  of  each  year  the  general  superin- 
tendent of  State  hospitals  of  California,  representing  the  California  State  Com- 
mission of  Lunacy,  forwards  a  report  to  the  Bureau  of  Medicine  and  Surgery, 
through  the  department,  showing  the  condition  of  all  patients  of  the  Navy  and 
Marine  Corps  under  treatment.  The  report  further  shows  the  number  of 
patients  admitted,  died,  discharged,  and  remaining  under  treatment. 

3154.  Under  the  terras  of  the  contract  the  expense  connected  with  the  care, 
maintenance,  and  support  of  insane  patients  is  $15  a  month  for  each  patient, 
and  such  expenses  are  paid  out  of  the  appropriation  "  Contingent,  Bureau  of 
Medicine  and  Surgery." 

3155.  Outfits  of  clothing  are  furnished  by  the  department  to  all  enlisted  men 
under  treatment.  In  the  case  of  enlisted  men  of  the  Navy  and  Marine  Corps 
whose  terms  of  enlistment  have  expired  the  hospital  authorities  are  authorized, 
under  the  terms  of  the  contract,  to  provide  such  patients  with  suitable  clothing 
at  the  rate  of  $2.50  per  month. 

3156.  All  expenses  connected  with  the  transportation  and  admission  of  in- 
sane patients  of  the  Navy  and  Marine  Corps  into  a  State  hospital  for  the  insane, 
California,  are  defrayed  from  appropriations  xmder  the  control  of  the  Bureau 
of  Navigation  and  the  Marine  Corps,  respectively.  All  expenses  connected  with 
the  discharge  of  enlisted  men  of  the  Navy  and  Marine  Corps  from  siuli  a  hospital 
and  their  transportation  to  a  receiving  ship  or  marine  post  for  discharge  from 


230         ^rANUAI.    FOK    THK    MKDICAL    DEPARTMKXT,   U.    S.    NAVV. 

tlie  naval  service  or  Marine  Corps  are  paid  froin  ai>pi-opiiations  under  the  con- 
trol of  the  Bureau  of  Navipation  and  of  the  Marine  Corps,  respectively. 

3157.  The  funeral  expenses  of  enliste<l  men  of  the  Navy  and  Marine  Corps 
who  die  while  under  treatment  in  a  State  hospital,  California,  are  defrayed  from 
appropriations  confinirent  Bureau  of  Medicii;e  and  Surgery  and  contingent 
Marine  Corps,   respectively. 

;{ir>H.  (Quarterly  payments  ar«>  made  by  the  de|)artment  for  the  care,  raaiii- 
lenaiue.  and  support  of  the  insane  patients  of  the  Navy  and  Marine  Corp< 
under  Treatment  in  a  State  liospital,  and  the  vouchers  are  made  payable  to 
the  ;reneral  superintendent  of  the  State  hospitals,  California. 

3159.  The  vouciier  shall  be  prepared  and  shall  bear  the  certificate  as  to 
correctness  by  the  medical  officer  in  command  of  rlie  naval  hospital.  Mare  Island. 
Cal.  It  is  approved  by  the  connuandanl  of  the  navy  yard.  Mar*-  Island,  Cal.. 
ami  by  the  Surgeon  General  of  llie  Navy.  The  I'ay master  General  of  the  Nav.\ 
directs  its  payment  by  the  Navy  pay  oltice,  San  Francisco,  Cal. 

3100.  rpon  the  admission  of  a  patient  into  a  State  hospital  the  hospital 
authorities  furnish  tiie  medical  officer  or  attendant  accompanying  such  patient 
with  a  receipt  for  the  person  and  the  personal  effects  of  llu^  patient.  Sucli 
receipt  shall  be  forwarded  by  the  medical  attendant  without  delay  to  the  com 
mandant  of  the  navy  yard.  Mare  Island,  for  the  tiles  of  his  office. 

3161.  The  bureau's  permit  for  the  admission  of  the  patient,  and  the  cer- 
tificate of  the  hospital  authorities  that  the  patient  has  been  admitted  into  the 
institution,  are  a  n(K;essary  preliminary  to  the  approval  and  transmission  to 
iJie  department  by  the  conunandant  of  the  vouchers  for  expenses  connected 
with  the  care  and  treatment  of  insane  patients  of  the  Navy  and  Marine  Corps 
in  a  State  ho.spital. 

3162.  The  superintendent  of  a  State  hospital  informs  the  commandant  of 
the  navy  yard.  Mare  Island,  Cal.,  as  soon  as  practicable  after  its  occurrence 
of  the  death  of  every  officer  or  enlisted  man  of  the  Navy  or  Marine  Corps  wlu» 
dies  while  undergoing  treatment  in  such  an  institution.  Upon  receipt  of  such  in- 
formation the  conunandant  causes  a  certificate  of  death  to  be  prepared  by  a 
Jiiedical  officer  under  his  command,  and  such  report  shall  be  forwarde<l  by  the 
conunandant  to  the  Bureau  of  Medicine  and  Surgery.  A  medical  officer,  when 
directed  to  make  an  examination  of  insane  patients  of  the  Navy  or  Marine 
Corps  inmates  of  a  State  ho.spital  for  the  insane,  shall  examine  these  patients, 
and  after  consultation  with  the  superintendent  shall  make  recommendations 
regarding  the  further  retention  of  these  patients  at  this  hospital,  also  the 
advisability  of  a  transfer  to  St.  Elizabeths  Hospital.  He  will  enter  up  to  riate 
the  health  record  in  each  case  if  it  has  not  already  been  done. 

3163.  For  the  information  of  the  superintendent  of  a  State  hospital  the  fol- 
lowing records  shall  accompany  each  patient  upon  bis  admission  into  the  hos- 
pital : 

(a)  Order  for  his  admission. 

(b)  Copy  of  report  of  medical  survey. 

{<;)  C<»py  of  hospital  ticket  (if  from  a  ship,  navy  yard,  or  special  duly). 

(d)  Health  rec<»rU.  (With  recjuest  that  a  concise  record  of  the  cas(>  be  con- 
tinued therein,  and  the  lecord  forwarded  with  the  patient  in  case  of  transfer, 
or  in  the  case  of  death,  desertion,  oi-  terminaljon  of  service  to  be  forwarded  to 
the  conunandant  of  the  n.avy  yard.  ^larc?  Island,  Gal.) 

(e)  The   Deparduent   of  Interior   form. 

3165.  Boards  of  medical  survey  reconunenrling  the  discliiirge  o1  harmless  in- 
.^iine  able  to  care  for  theniselves  or  be  cared  for  by  Irieiuls  or  th«'ir  families, 
should  enter  on  the  report  of  survey  the  stntc-ment.  "Not  a  menace  to  him.self 
or  1(»  the  connnnnity." 

3166.  Thirty  day.s'  notice  of  the  contemplated  discharge  of  an  enlisted  man 
or  member  of  the  auxiliary  force  is  re(juirwi  to  be  ghen  to  the  superintendent 
of  St.  Elizabeths  Hospital  and  to  the  SecnMary  of  tlu>  Interior  to  enable  the 
latter  to  re(|uest  the  Attorney  General  to  have  the  sanity  of  (he  Individual 
determined,   as  re(iulred   under   ilie  laws  of  (he   I>is(rl<'(   of  ('olumbia       (M    \ 

s.  No.  rji.ir.fK) 


.YVA-/I  .a  .u  .t: 


CHAPTER  19. 


THE  xVAVAL  MEDICAL  SCHOOL.  ■■ 

Skction  1. — Rkcutlations   Relating  to  the  Naval  Medical  School. 

3201.  Order  relating  to  its  establishment.  General  Order  No.  89,  May  21, 
1902. 

3202.  Order  changing  name.    Department  letter  No.  19931,  May  26,  1905. 

3203.  Under  the  supervision  and  control  of  the  bureau.    112901  (3). 

3204.  Microscopical  outfit  and  accessories  to  be  forwarded  to  Naval  Medical 
School  when  ship  goes  out  of  commission.     (12124  (1)  ?>.),  .^ 

Skction  2. — Insteuctioks  Relating  to  the  Naval  MEoicAL  ScHbOL.' ;  '" 

3211.  The  medical  officer  in  command  of  the  Naval  Medical  School  is  charged 
with  all  duties  relating  to  its  administration,  and  is  responsible  for  its 
efficiency. 

3212.  The  faculty  will  consist  of  the  officers  ordered  to  the  school  as  instruc- 
tors. The  medical  officer  in  command  shall  preside  over  and  conduct  all  faculty 
meetings,  and  the  junior  member  of  the  faculty  shall  keep  a  record  of  all  pro- 
ceedings. Meetings  of  the  faculty  will  be  held  from  time  to  time  as  may  be 
considered  advisable  by  the  medical  officer  in  command  and  the  bureau  shall 
be  kept  advised  of  any  changes  regarded  as  desirable  to  improve  the  efficiency 
of  the  school  as  a  whole  or  in  any  individual  branch.  At  such  meetings  de- 
ficiencies of  individual  student  officers  will  also  be  given  careful  consideration. 

3213.  Each  member  of  the  faculty  shall  consult  with  the  medical  officer  in 
command  and  shall  submit  a  syllabus  of  his  course  when  directed,  for  the  offi- 
cial files  of  the  school. 

3214.  Upon  the  completion  of  the  session  and  at  such  otiier  times  as  may 
be  considered  desirable,  examinations  will  be  held.  The  final  examination  will 
be  conducted  by  a  board  to  determine  fitness  for  admission  to  the  Medical  Corps. 

3215.  At  the  beginning  of  the  school  year  members  of  the  Naval  Reserve 
Force  who  may  have  been  selected  for  that  purpose  will  be  ordered  to  the 
Naval  Medical  School  for  duty  and  the  prescribed  course  of  instruction. 

3216.  Medical  officers  who  desire  to  avail  themselves  of  the  course  of  in- 
struction or  of  any  of  its  branches  may  be  assigned  to  the  school  for  such  pur- 
pose upon  recommendation  by  the  bureau. 

3217.  By  permission  of  the  bureau  medical  officers  who  desire  to  undertake 
research  work,  and  who  have  been  detailed  for  duty  in  Washington  or  other 
place,  may,  when  their  services  can  be  spared,  avail  themselves  of  the  advan- 
tages of  the  laboratories  for  their  investigations.  .    .     ,,         ,.  j 

3218.  The  course  of  instruction  for  a  session  will  cover  a  period'  o^rtbt  \^^b 
than  five  months,  and  embrace  the  following :  Naval  and  general  hygiehei  haivat 
and  operative  surgery,  tropical  medicine,  pathology,  medical  zoology,  bacteri- 
ology, serology,  ophthalmology,  chemistry,  psychiatry,  roentgenology,  and  elec- 
tro-therapeutics. Hospital  Corps  drills,  duties  of  the  medical  officer  in  Navy 
Regulations  and  Naval  Instructions  and  Manual  for  the  Medical  Department, 
and  such  other  subjects,  including  naval  law,  epidemiology,  quarantine,  etc.,  as 
may  be  feasible.  In  all  these  courses  special  attention  shall  be  given  to  tho^e 
features  pertaining  to  the  practical  work  of  naval  medical  officers.  ' 

2.31  '^ 


232        MANUAL   FOR    THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

3219.  Student  officers  shall  be  required  to  be  present  at  all  the  exercises 
of  the  school  unless  excused  by  the  medical  officer  in  command  or  other  com- 
petent authority.  They  shall  be  considered  on  duty  during  the  hours  prescribed 
for  school  work,  and  shall  be  required  to  conform  in  all  respects  to  the  United 
States  Navy  Kei^ulations  and  Naval  Instructions  and  such  orders  as  may  be 
issued  from  time  to  time  for  their  guidance  and  the  maintenance  of  discipline. 

3220.  Applications  from  medical  oHicers  of  ships  and  stations  for  the  loan  of 
books,  and  duplicate  copies  of  current  periodicals  in  the  school  library,  should 
be  addressed  to  the  medical  officer  in  command.  It  is  the  intent  to  have  the 
library  of  the  school  utilized  by  medical  officers  generally  so  far  as  may  be 
practicable,  but  receipts  will  be  required,  and  officers  securing  publications  will 
be  held  responsible  for  their  prompt  return. 

Section  3. — Instructions  Relating  to  Collecting,  Pbesebving,  and  Fobward- 
IN6  Specimens  to  the  School. 

3221.  The  laboratories  of  the  Naval  Medical  School  are  prepared  to  make 
examinations  of  and  furnish  reports  on  pathological,  bacteriological,  and  other 
specimens.  Such  specimens  and  samples  should  be  forwarded  direct  to  the 
medical  officer  in  command  of  the  school,  properly  packed,  and  be  accompanied 
by  a  report  made  on  a  prescribed  form  issued  to  medical  officers  upon  appli- 
cation. 

3222.  Blood  for  "Wassermann  reaction  should  be  taken  from  a  vein  or  col- 
lected in  a  Wright's  tube,  and  set  aside  until  the  clear  serum  separates  from 
the  clot.  The  serum  should  then  be  removed  by  means  of  a  capillary  pipette 
and  forwarded  in  sealed  capillary  tubes  or  small  vials. 

3223.  Samples  of  which  a  chemical  examination  is  desired  should  be  ac- 
companied by  an  explicit  statement  as  to  the  kind  and  extent  of  examination 
wanted.  Such  samples  should  be  adequate  in  quautitj-.  When  it  is  necessary 
to  use  preservatives  due  care  must  be  exercised  in  their  selection  that  inter- 
ference with  subsequent  examination  may  be  avoided. 

3224.  Pathologic  tissue,  including  gross  and  microscopic  specimens  and  blood 
smears,  parasitic  worms  and  their  ova,  mosquitoes,  flies,  fleas,  ticks  and  other 
parasitic  insects,  snakes,  poisonous  fish,  and  any  other  specimens  of  medical 
interest,  especially  in  the  Tropics,  are  desired  and  required  for  the  school  col- 
lection. Specimens  of  ordinarily  little  value  may  be  of  interest  because  of  the 
remote  or  unusual  locality  in  which  Ihey  were  collected. 

3225.  The  simplest  method  of  preserving  tissues  for  microscopic  study  is  to 
place  small  pieces,  not  over  h  inch  (5  mm.)  thick,  in  a  10  i>er  cent  solution  of 
formalin  (4  per  cent  formakk'hyd)  for  10  to  24  hours,  then  transfer  them  to  70 
per  cent  alcohol,  in  which  they  may  be  left  indefinitely.  Feces  containing  ova 
may  be  preserved  by  mixing  with  an  equal  volume  of  10  per  cent  formalin. 
Worms  may  be  preserved  in  10  per  cent  formalin  for  from  2  to  24  hours,  ac- 
cording to  size,  and  then  transferred  to  lacto-phenol  solution  (glycerin  2,  water  1. 
phenol  cryst.  1,  lactic  acid  11  ;  nematodes  may  be  placed  directly  in  hot  (SO  C.) 
70  per  cent  alcohol  and  allowed  to  remain  indefinitely. 

3226.  A  separate  label  should  be  .sent  with  each  specimen,  giving  full  in- 
formation jiarticuhirly  covering  the  following  jioinls:  Name,  sex,  age,  and  race 
of  patient,  with  pertinent  clinical  notes;  animal  and  organ  from  which  parasite 
was  collected;  locality  in  which  specimen  was  collected;  locality  of  probable 
infection;  method  of  i)reservation. 

3227.  Double  tin  mailing  cases,  with  specimen  bottles  suitable  for  average 
siJecimens,  have  been  sent  to  naval  hospitals  and  certain  tropical  stations. 
These  and  other  special  bottles  and  cases  will  be  supplied  from  the  school  upon 
request. 

3228.  Typhoid  bacilli  emulsion  for  Widal  test,  culture  tubes  and  blcKul  stain 
and  other  bacteriological  siiiiplics  listed  on  the  supply  tnble  as  procurable  from 
the  school,  should  be  applied  for  direct  by  letter  or  telegram  addressetl  to  the 
meilical  officer  In  command. 


MANUAL  FOR   THE    MEDICAL   DEPARTMENT,  U.    S.    NAVY.         233 

Under  section  473,  Postal  Laws  and  Regulations,  are  given  restrictions 
imposed  in  regard  to  the  transmission  through  the  mail  of  pathological  or  dis- 
eased tissues,  blood  or  syphilitics,  tubercular  sputum,  liquid  cultures,  etc. 

Medical  officers  contemplating  the  use  of  the  mails  for  transmission  of 
material  that  might  be  forbidden,  or  for  Avhich  specific  directions  are  given, 
should  apply  for  information  to  the  Post  Office  Department,  Washington,  D.  C. 

Section  4. — Naval  Medical  Correspondence  Course. 

3230.  Upon  recommendation  of  the  bureau  the  Navy  Department  on  Jan- 
uary 24,  1916,  authorized  the  establishment  of  a  correspondence  course  for 
medical  officers  of  the  Naval  Reserve  Force.  This  course  is  also  open  to  acting 
assistant  surgeons  of  the  Navy  and  to  medical  officers  of  the  Naval  Militia. 

Acting  assistant  surgeons  and  officers  of  the  Naval  Reserve  Force  on  active 
duty  are  required  to  talie  the  course,  unless  they  have  previously  completed  the 
regular  course  of  instruction  at  the  Naval  Medical  School. 

The  course  is  administered  by  the  Naval  Medical  School.  The  object  is  to 
promote  the  efficiency  of  these  officers  by  systematic  instruction  in  naval  forms, 
customs,  regulations,  and  procedures. 


>?    FAnVi/.  .: 


CHAPTER  20. 


SUPPLIES  AND  SERVICES  ;  REQUISITIONS  :  PUBLIC  BILLS  AND 

VOUCHERS. 

SiccTioN  1. — IjA\n'.s  Relating  to  the  Pkocurement  of  Supplies,  Services,  etc. 

3301.  Regulations  of  supplies.    Sec.  1549,  R.  S. 

3303.  Advertisements  for  proposals.     Sec.  37(K),  R.   S. ;  acts  June  '22.  1874, 
.Tan.  27,  1894. 

3303.  Naval  supplies,  how  purchased  and  issued.     Acts  Mar.  2,  1891,  Mar. 
2,  1907. 

3304.  Supplies  to   be   deemed   naval   and   not   bureau    supplies.     Act   June 
30,  1890. 

3305.  Contracts  for   the  naval  and   military  service,   liuw  controlled.     Sec. 
3714,  R.  S. ;  act  Feb.  27,  1877. 

3306.  Naval  supplies  to  be  furnished  by  contract.    Sec.  3718,  R.  S. ;  act  .Tune 
30,  1890. 

3307.  Purchases  that  may  be  made  witliout  advertisinsj.     Sec.  3721,  R.  S. 

3308.  Contracts  to  be  in  writins.    Sec.  3744,  R.  S. 

3309.  Oath  to  contract.    Sec.  374.5,  R.  S. 

3310.  Penalty  for  omitting  returns.     Sec.  3741).  R.  S. 

3311.  Instructions.     Sec.  3747,  R    S. 

3312.  Returns  office.    Sees.  .512,  513,  .514,  515,  R,  S. 

3313.  Original  contract  to  be  deposited  with  Auditor  for  the  Navy  Depart- 
ment.   Act  July  31,  1894. 

Section  2. — Navy  Regulations  and  Naval  Instructions  Relating  to  These 

Subjects. 

3321.  Bureau  to  require  and  have  custody  of  all  medical  supplies.    R  133  (4) 

3322.  Medical  outfits  for  ships.     R  4623. 

3323.  Requisitions   and   supplies   from   any    other   department   of   the   ship. 
I  4422. 

3324.  Requisitions  for  supplies  or  services  on  ships  at  naw  vards  in  emer- 
gencies. I  4472  (6). 

332r>.  General  instructions  as  to  open-purchase  requisitions.     I  4654  (1). 

3326.  Open  purcha.se  in  emergencies.    I  4654  (6). 

3327.  Requisitions  for  supplies  from  ships  at  navy  yards.    I  4475. 

3328.  Requisitions  foi   supplies  (b   opf'n  purchase  on  shore,  how  niade,  ap- 
proved, and  fulfilled.     1  4657.  .     "      .,,,,,   ),,«..■,>      •  i  ■ 

3320.  Medical  supplies,  instruments,  etc.,  to  be  selected  by- officers' represent- 
ing the  departments  requiring  for  them.     I  4480. 

3330.  Inspection  of  supplies  purchased.    I  3225;  I  4678. 

3331.  Public  bills  to  be  prepared  without  delay.    I  4691. 

3332.  Approval  of  public  bills  and  preparation  of  vouchers.    I  448^. 

3333.  Disposition  of  bills  and  requisitions.     I  4484. 

3334.  Disposition   of  medical    supplies   upon   a    ship   going   out   of  commis- 
sion.    I  2124. 

235 


236        MANUAL   FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

Section  3. — Laws  and  Decisions  Rklating  to  Mf:dicat.  Sekvices  and  Supplies. 

3341.  Medicines  and  medical  attendance.     Sec.  1586,  R.  S. 

3342.  Keimburseinent  for  dental  services  is  authorized  after  injury  incurred 
in  line  of  duty.     (Rulin;,',  Comptroller's  Ollice,  May  23,  1913.) 

3343.  Officers  proceeding  under  orders  entitled  to  medical  attendance. 
(Rulinii;,  Comptroller's  Office,  Feb.  11,  1902.) 

Section  4. — Navy  Regulations  llELAfrNo  to  Medicines  and  Medical 

Attendance. 

3351.  Expenses?  for  medical  attendance,  when  allowed.    R  4534  (1). 

3352.  Sickness  or  injury,  to  he  reported.    R  4534  (2). 

3353.  Claims  for  expen.ses.    R  4534  (3). 

3354.  Treatmfent  by  specialist.     R  4.534  (4). 

3356.  Expenses  for  enlisted  men.    R  4.534  (5). 

335(>.   Where  there  is  no  Government  hospital.     R  4534  (6). 

3357.  Sick  officers  entitled  to  attendance  within  or  without  a  naval  hospital. 
I  3222. 

Section  5. — General  Information  Relating  to  Medicines  and  Medical 

Attendance. 

3361.  All  officers  of  the  Navy  and  Marine  Corps  on  duty  are  entitled  to  the 
professional  services  of  medical  officers  of  the  Navy  who  are  detailed  for  the 
purpose.  When  medical  officers  treat  officers  who  are  not  regularly  under  their 
care,  they  shall  forward  medical  histories  of  such  cases  to  the  Bureau  of  Medi- 
cine and  Surgery.     I  3222. 

3362.  Under  the  laws  and  regulations,  expenses  incurred  by  offifers  of  the 
Navy  for  medicines  and  medical  attendance  shall  not  be  allowed  unless  they 
were  incurred  when  on  duty,  and  the  medicines  could  not  have  been  obtained 
from  naval  medical  supplies,  or  the  attendance  of  a  naval  officer  could  not  have 
been  had,  except  as  provided  in  article  li  4534  (4). 

3363.  The  regulations  require  that  officers  on  duty  where  the  services  of  a 
naval  medical  officer  are  not  available  shall  report  their  condition  to  the  Sur- 
ge(m  General  of  the  Navy  as  soon  as  practicable  after  the  occurrence  of  their 
sickness  or  injury  in  order  that  their  claims  for  expenses  may  receive  immediate 
attention. 

3364.  All  claims  for  expenses  incurred  by  officers  of  the  Navy  for  medicines 
and  me<lical  attendance,  accompanied  by  duplicate  receipted  bills,  shall  be  tor- 
warded  to  the  Surgeon  General  for  examination  and  approval.  A  voucher 
covering  the  claim  for  such  expenses  will  then  be  prepared  in  the  Bureau  of 
Medicine  and  Surgery  and  forwarded  to  Uie  officer  concerned  for  signature. 
Upon  the  approval  of  the  voucher  by  the  Surgeon  General,  the  Paynuisler  Gen- 
eral will  order  its  payment  by  a  designated  pay  officer. 

3365.  Rills  for  medical  attendance  upon  enlisted  men  on  recruiting  duty  for 
medicines  and  surgeon's  necessaries  and  for  treatment  in  hospital  shall  i)e  prop- 
erly made  out  and  certified  to  by  the  medical  officer  and  submitted  to  the  Bu- 
reau of  Medicine  xin<l  Surgery  before  jtayment,  accompanied  by  letter  of  atlvice. 
giving  the  disease  or  injury  on  acc(i\int  of  which  the  expenses  were  incurred. 
[']Hm  all  copies  of  public  bills  for  such  exixMises  the  medical  officer  will  certify 
that  Navy  medical  supplies  were  not  available,  or  that  the  .services  of  a  Navy 
medical  officer  could  not  be  had,  or  that  treatment  in  hospital  was  necessary. 
Expenses  for  medicines  for  or  medical  attendance  upon  a  naval  officer  on  re- 
cruiting duty  will  bo  paid  by  the  officer  receiving  tlu-ni  and  claim  for  Iho  ex- 
pense  so  incurred  submitted  to  the  Surgeon  (Jeiicral  in  accordance  with  article 
R  4.534. 


MANUAL   FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.         237 

Section  6. — Instructions  Relating  to  the  Preparation  and  Disposition  of 
Requisitions,  Public  Bills,  etc. 

3371.  All  purchases  and  contracts  for  supplies  or  services  for  the  naval 
service  shall  be  made  by  or  under  the  direction  of  the  chief  officer  of  the 
Department  of  the  Navy.    Sec.  3714,  R.  S. ;  I.  4651. 

3372.  All  purchases  or  contracts  for  supplies  or  services,  in  any  of  the 
departments  of  the  Government,  except  for  personal  services,  shall  be  made 
by  advertising  a  sufficient  time  previously  for  proposals  respecting  the  same, 
when  public  exigencies  do  not  require  the  Immediate  delivery  of  the  articles  or 
the  performance  of  the  service.  When  immediate  delivery  or  performance  is 
required  by  the  public  exigency,  the  articles  or  service  required  may  be  pro- 
cured by  open  purchase  or  contract,  at  the  places  and  in  the  lUMnupv  in  w'lich 
articles  are  usually  bought  and  sold  or  such  services  engaged  between  In- 
dividuals.    Sec.  3709,  R.  S. 

3373.  That  hereafter  the  purchase  of  supplies  and  the  procurement  of  services 
for  all  branches  of  the  naval  service  may  be  rriade  in  open  market  in  the 
manner  common  among  business  men.  without  formal  contract  or  bond,  when 
the  aggregate  of  the  amount  required  does  not  exceed  .$500,  and  when,  in 
the  opinion  of  the  proper  administrative  officers,  such  limitation  of  amount  is 
not  designed  to  evade  purchase  luider  formal  contract  or  bond,  and  equally 
or  more  advantageous  terms  can  thereby  be  secured.  Naval  act  of  March 
2,  1907. 

3374.  When  the  United  States  enters  into  a  contract  with  any  of  its  cit'zens 
it  stands  on  identically  the  same  footing  as  an  individual,  and  is,  therefore, 
subject  to  the  same  obligations  and  invested  with  the  same  rights  as  exist 
against  or  in  favor  of  any  citizen. 

3375.  Requisitions  will  be  submitted  to  the  bureau,  accompanied  by  so  many 
memorandum  copies  as  may  be  required,  and  numbered  in  series  by  fiscal  years. 
The  memorandum  copies  of  the  requisition  are  filed  in  the  Bureau  of  Medicine 
and  Surgery;  in  the  Bureau  of  Supplies  and  Accounts;  and  in  the  Navy  pay 
oflice  where  the  purchase  is  made ;  and  the  original  of  the  requisition,  attached 
to  the  public  bill,  is  finally  filed  in  the  office  of  the  Auditor  for  the  Navy 
Department.  One  memorandum  copy  of  each  requisition  and  public  bill  for 
supplies  or  services  (except  supplies  on  Form  B  and  Form  4)  shall  be  plainly 
stamped  or  inscribed  across  its  face  "  Copy  for  accounting  section.  Bureau  of 
Supplies  and  Accounts." 

3376.  For  the  better  preservation  of  data  concerning  requisitions  and  public 
bills,  and  to  obviate  the  necessity  for  entering  numerous  items  in  the  bill 
book,  ribbon  copies  of  all  requisitions  and  public  bills  pertaining  thereto  will 
be  filed  in  jackets  marked  with  the  serial  number  of  the  requisitions. 

3377.  Requisitions  will  give  such  descriptions  of  articles  or  services  as  will 
enable  purchasing  pay  officers  and  bidders  to  understand  readily  what,  is 
required.  As  a  rule  Navy  standard  specifications  will  be  used,  reference  being 
made  to  the  appropriate  one  by  number  and  letter.  Whenever  it  is  impracti- 
cable to  give  such  full  information  on  the  face  of  requisitions,  specificat'ons 
will  be  written  in  full  on  separate  paper  and  attached.  When  various  articles 
are  included  in  a  requisition,  items  of  a  similar  nature  will  be  arranged  con- 
secutively. 

3378.  The  names  of  acceptable  bidders  may  be  entered  on  the  face  of  the 
memorandum  copies  as  a  guide  to  the  purchasing  officer  in  inviting  proposals. 
Explanatory  notes  necessary  for  the  information  of  the  bureau  will  be  made 
to  show  (a)  articles  required  to  replace  such  as  have  been  condemned  by 
survey,  with  date  of  bureau  approval  of  the  survey,  and  (ft)  additional  articles 
required  for  the  proper  maintenance  of  the  station ;  the  purposes  for  which  they 
are  required  will  be  noted  in  the  space  set  aside  for  that  purpose.  The  estimated 
cost  will  be  entered  opposite  each  item  on  all  memorandum  copies  and  the  total 
in  ink.  If  necessary  to  a  complete  understanding  thereof,  the  requisition  will 
be  accompanied  by  a  letter.     I  4654. 


t>38         MANUAL    I'OK    TllK    xMEUlCAL    DEPARTMENT,    V.    S,    NAVY. 

33i».  Requisitions  will  not  call  for  proprietary  articles  in  any  case  where 
it  can  possilily  be  avoided,  and  when  callinj?  for  proprietary  articles  will  be 
indorsed  "The  above  ar)i<les  and  no  others  will  answer  the  necessities  of  the 
service." 

8380.  If  all  the  articles  bought  under  a  requisition  are  not  embraced  iu  one 
jiublic  bill,  on  those  public  bills  to  which  the  requisition  is  not  appended  a  note 
will  be  made  stating  the  date  and  amount,  with  dealer's  name,  of  the  publi«- 
bill  to  which  it  is  attached.  Vouchers  shall  bear  a  statement  whether  complete 
or  not.  and,  if  not  complete,  the  balance  (liability)  due. 

3381.  Items  of  requisitions  will  be  numbered  in  the  margin  on  the  left,  and 
items  of  public  bills  will  be  similarly  numbered,  item  for  item,  with  the  item 
numbers  of  the  requisition. 

3382.  Annual  requisitions  for  "miscellaneous  expenses  '  at  naval  hosititals 
will  be  utilized  for  the  purposes  indicated  by  the  phraseology  thereof  when  the 
care  of  the  sick  requires  the  delivery  of  articles  or  the  performance  of  service 
under  circumstances  not  admitting  of  delay  sufficient  to  obtain  the  specitii- 
approval  of  the  bureau.  This  character  of  requisition  is  permitted  in  order 
to  obviate  the  too  frequent  use  of  the  special  exigency  voucher.  The  estimated 
cost  thereon  will  not  be  regarded  as  an  expendable  allowance.  Public  bills 
made  thereunder  will  not  be  delayed  until  the  end  of  the  quarter. 

3383.  Stores  retjuired  for  hospital,  yard,  and  station  use.  kept  in  stock  by 
tlie  general  storekeeper  under  the  naval-supply  fund,  will  be  obtained  on  stub 
requisitions.  Stores  for  hospitals  will  be  charged  to  naval  hospital  fund. 
Stores  for  navy  yards  and  stations  will  be  charged  to  "  Medical  Department " 
or  "  Contingent,  M.  &  S.,"  as  the  case  may  be. 

3384.  Public  bills  will  be  made  with  such  number  of  memorandum  copies  as 
may  be  refpiired.  The  approval  of  the  commandant  and  of  the  Paymaster 
General  is  not  required.  They  will  be  forwarded  for  payment  to  the  pay 
otlicer  who  placed  the  order,  or  to  the  Bureau  of  Supplies  and  Accounts. 

3385.  Signatures  will  be  affixed  to  certificates,  approvals,  and  acknowledg- 
ments of  deliver^'  upon  the  originals  of  public  bill.*?.  The  memorandum  copies 
will  be  true  copies  thereof,  except  that  the  places  for  signature  shall  be  coni- 
pletetl  in  the  several  offices  through  which  public  bills  are  required  to  pass  by 
stamping  or  typing  thereon  the  names. 

3386.  Metlical  officers  will  be  held  responsible  for  the  correctness  of  the  cer- 
tificate that  supplies  have  been  inspected,  pa.ssed,  and  received  into  store,  etc.. 
and  purchasing  pay  oflicers  will  be  held  responsible  for  the  correctness  of  the 
prices,  extensions,  and  footings;  both  officers,  however,  should  exercise  special 
care  to  secure  accuracy  in  publi<;  bills  both  as  to  figures  and  appropriations. 

3387.  Public  bills  will  not  be  delayed  for  the  completion  of  statistical  and 
lither  re)'i'rts  and  returns,  and  at  the  close  of  the  fiscal  year  medical  officers 
will  exercise  especial  care  that  all  unsatisfied  requisitions  and  contracts  are 
promptly  completed  and  public  bills  rendered. 

3388.  Public  bills  for  deliveries  accepted  shall  be  preparetl  and  forwarded 
without  delay,  in  order  that  dealers  may  have  no  occasion  to  address  letters  of 
inquiiw  or  complaint  to  the  department.     (Art.  I  4691.) 

3.^8ih  Dealer's  bills  will  be  attached  (pasted)  to  the  upper  left-hand  corner 
of  all  public  bills  and  mu.st  be  certified  by  the  payee  to  be  "Correct  and  just. 
Payment  not  received."  This  certificate  by  the  payee  must  be  on  all  public 
bilis,  whether  ojien  purchase,  Navy  pay  office  c<.ntract,  bureau  contract,  buresui 
order,  or  special  exigency. 

33;)0.  The  original  of  the  public  bill  will  be  the  ribbon  copy.  The  niemo- 
ran«lum  copies  will  be  made  by  carbon  process.  The  totals  of  all  public  bills 
will  be  written  across  the  face  in  words. 

3891.  The  phraseology  of  forms  will  not  be  iiltcred,  iind  the  wording  of  the 
certifictite  as  to  supplhvs  and  services  will  not  be  changed  when  only  one  or 
the  other  Is  furnislnHl  or  performed,  lleciuisilions  and  public  bills  will  bear 
the  appropriation  and  subhead  of  appropriation  as  herelnaffpr  given.     Kntrlo*; 


MANUAL    FOR    THE    MEDICAL    DEPARTMENT,   U.    S.    NAVY.         239 

will  be  made  on  public  bills  of  the  number  and  date  of  requisition  or  contract: 
and  when  contract  follows  a  requisition  the  number  of  the  requisition  as  well 
as  the  number  and  date  of  the  contract  will  be  given. 

3392.  Vouchers  will  be  made  in  favor  of  the  dealer  from  whom  the  supplies 
have  been  obtained  or  the  person  who  has  rendered  the  service.  They  will 
never,  for  convenience,  be  made  in  the  name  of  a  person  employed  on  the 
station. 

3393.  Services  or  material  supplied  in  an  emergency  should  be  covered  by 
requisition,  either  before  or  after  the  transaction,  in  order  to  comply  more  fully 
with  the  law  and  also  as  a  matter  of  record  and  future  reference.  In  every 
instance  where  it  is  Impracticable  for  the  purchasing  pay  officer  to  take  advance 
action,  due  to  sudden  emergency  or  other  unforeseen  contingency,  it  is  of  the 
utmost  importance  that  a  purchasing  pay  office  place  "  formal "  order  or  con- 
tract on  requisition  prepared  to  cover  the  transaction,  and  when  requisition  is 
prepared  a  full  and  detailed  statement  as  to  the  necessity  for  advance  action 
shall  be  given.  Section  3744  of  the  Revised  Statutes  provides  that  every  con- 
tract be  reduced  to  writing  and  signed  by  contracting  parties.  Without  con- 
sidering the  requirements  of  the  regulations  and  regardless  of  the  fact  that 
authority  to  place  orders  and  contracts  is  vested  in  the  purchasing  pay  officers 
under  the  cognizance  of  the  Bureau  of  Supplies  and  Accounts,  it  may  be  stated 
that  there  are  formalities,  some  required  by  statute,  others  by  directions  from 
the  department,  which  must  be  attended  to  before  the  transaction  is  thoroughly 
complete.  For  instance,  the  original  of  each  contract  or  order  must  be  for- 
warded to  the  Auditor  for  the  Navy  Department ;  a  copy  of  each  contract  must 
be  forwarded  to  the  Returns  Office,  Department  of  the  Interior;  bills  must  be 
received   in   duplicate,   properly    certified;    certification   of   delivery    must   be 

secured,  etc.  ^.     .  ,     ^ 

The  Bureau  of  Supplies  and  Accounts  desires,  so  far  as  may  be  practicable,  to 
avoid  the  continued  use  of  the  "  special  exigency  public  bill  "  without  embar- 
rassing the  efficient  and  prompt  transaction  of  business  at  naval  hospitals. 

3394.  Special  exigency  public  bills  were  prepared  by  the  Second  Comptroller 
of  the  Treasury  for  the  especial  use  of  the  Medical  Department  of  the  Navy,  in 
recognition  of  the  fact  that  special  exigencies  arise  in  the  care  of  the  sick  and 
the  preservation  of  hospital  buildings  when  services  or  supplies  can  not  be 
obtained  under  the  authority  of  existing  contracts  or  requisitions.  These 
public  bills  will  be  used  only  at  hospitals  and  shore  stations  in  cases  of  sudden 
emergency,  such  as  broken  water,  steam,  and  gas  pipes;  falling  walls  and  ceil- 
ings; broken  heating  and  cooking  apparatus;  when  articles  for  the  care  and 
welfare  of  the  sick  are  immediately  necessary  ;  and  for  funeral  expenses.  Medi- 
cal officers  rendering  special  exigency  public  bills  will  assume  the  entire  re- 
sponsibility for  them  and  will  certify  to  the  methods  by  which  services  or 
articles  were  secured,  to  the  correctness  of  the  charges,  and  will  make  the 
proper  entries  on  the  reverse  of  the  forms.  An  additional  certificate  will  be 
made  by  the  medical  officer  across  the  fact  of  the  voucher  as  to  the  necessity 
for  the  procurement  of  supplies  or  services,  in  which  he  will  quote  or  state  the 
authority  or  necessity  for  incurring  the  expense.  This  form  will  be  used  at 
hospitals  when  the  procurement  of  supplies  becomes  necessary  owing  to  the 
failure  of  contractors.  When  so  used  a  concise  statement  will  be  made  of  the 
circumstances,  the  name  of  the  delinquent  contractor,  and  the  date  and  number 
of  the  contract.  Special  exigency  public  bills  will  be  forwarded  through  the 
Bureau  of  Supplies  and  Accounts  for  payment.  The  bureau  has  endeavored  to 
discourage  the  too  frequent  and  the  sometimes  unjustified  use  of  this  form  of 
public  bill,  and  has  brought  to  the  attention  of  commanding  officers  of  hospitals 
the  fact  that  the  responsibility  accepted  by  them  in  procuring  supplies  and  serv- 
ices and  making  public  bills  for  same  is  without  warrant  of  statute  law,  and 
that  the  special  exigency  form  of  public  bill  is  only  allowed  by  the  comptroller 
for  special  emergencies  arising  in  the  care  of  the  sick.  In  every  instance  where 
practicable  supplies  and  services  will  be  procured  by  the  purchasing  pay  officer 
and  in  sudden  emergencies  requisitions  to  cover  the  purchases  thus  made,  with 


240        MANUAL  FOR   THE   MEDICAL  DEPARTMENT,   U.    S,    NAVY. 

suitable  notation  thereon,  will  be  submitted  for  subsequent  approval  by  the 
bureau. 

3395.  Instructions  in  relation  to  the  preparation  of  requisitions  upon  the 
medical  supply  depots  will  be  found  in  detail  on  the  forms  used  therefor  and  in 
the  supply  table. 

339<>.  Requisitions  afloat  in  home  ports  and  afloat  and  asliore  abroad  will 
be  prepared  upon  the  forms  provided  by  the  bureau  when  it  is  desired  that 
stores  shall  be  forwarded  from  a  medical  supply  depot  and  upon  ships'  forms 
when  the  stores  are  to  be  purcliased  upon  the  station.  Medical  oflicers  on  shore 
duty  within  the  United  States  when  submitting  requisitions  will  use  Form  B 
and  Form  4  for  supplies  listed  in  the  supply  table  and  for  other  supplies  will 
use  Form  1. 

3397.  Duplicating  proces.ses  in  the  preparation  of  requisitions  aud  public  bills 
are  commended,  as  they  insure  accuracy  of  copies.  Care  will  be  exercised  that 
all  copies  are  entirely  legible,  and  all  footings  will  be  make  in  ink. 

3398.  Medical  officers  shall  see  that  all  public  bills  bear  the  appropriation 
designated  by  tlie  requisition. 

3399.  The  expense  of  maintenance  of  hospitals  (including  supplies  and  pro- 
visions, fuel,  medicines,  furniture,  equipment)  and  of  repairs  to  buildings,  roads, 
fences,  etc.,  and  of  repairs  of  furniture  and  equipment,  is  a  charge  against  the 
naval-hospital  fund.  The  naval-hospital  fund  is  only  available  for  hospital 
expenses.  •• 

3400.  Other  appropriations  chargeable  with  hospital  expenses  are  "  Contin- 
gent, M.  and  S.,"  for  burial  of  the  dead  ;  purchase  of  horses,  wagons,  trees,  seeds, 
etc. ;  "  Bringing  home  remains,"  for  tran.sportation  of  remains  when  authorized  by 
the  bureau ;  "  Medical  Department,"  for  pay  of  civil  employees  on  the  pay  roll ; 
"Pay  of  the  Navy,"  for  rental  of  quarters;  "Pay,  miscellaneous."  for  tele- 
grams, telephones,"  and  postage  stamps ;  "  Freight,  S.  and  A.,"  for  expressage 
and  freight. 

Section  7. — 1'ublic  Bills  Afloat. 

3401.  Purchases  on  board  ship  are  made  by  the  pay  officer  of  the  ship,  ap- 
proved by  the  captain  or  by  the  commander  in  chief.  The  selection  of  the 
articles  is  made  by  the  medical  officer. 

3402.  Public  bills  for  all  supplies  and  services  for  the  Medical  Department 
on  board  ships  on  foreign  stations  are  made  out  on  forms  furnishe<l  by  the 
Bureau  of  Supplies  and  Accounts. 

3403.  The  pay  officer  of  the  ship  furnishes  the  medical  ofllcer  with  copies 
of  all  public  bills  relating  to  his  department  for  the  files  of  the  Medical  Depart- 
ment of  the  ship. 

Section  8. — Naval  Mkdical  Supply  Depot  Priced  Invoices,  Ashore  and  Afloat. 

3411.  There  are  no  public  ])ills,  properly  speaking,  accompanying  naval 
medical  supply  depot  requisitions. 

3412.  The  completion  of  all  such  requisitions  is  accomplished  by  entering 
the  aggregate  value  (priced  invoice)  of  all  stores  received  on  the  back  of  the 
last  sheet  of  the  particular  form  used,  and  when  they  have  been  receipted  by 
the  officer  requiring  for  tlie  stores  and  returned  to  the  naval  medical  supply 
(l('r»ots,  thev  are  considered  in  the  light  of  public  bills. 

3413.  The  accomplishment  of  all  naval  medical  supply  depot  requisitions  and 
l)ri<ed  invoices  is  confined  to — 

(tt)   The  medical  officer  submitting  the  requisition. 

(b)  The  P.ureau  of  Medicine' and  Surgery,  where  the  re^iuisitioii  is  approved, 
disapproved,  or  modified. 

(c)  The  inedii  al  officer  in  command  of  the  naval  medical  supply  depot,  wliere 
the  re(|Ulsition  is  filleil  and  delivered  to  the  hospital,  station,  or  ship  from 
which  submitted. 


MANUAL -FOR  THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY.         241 

3414.  Supplies  obtained  on  naval  medical  supply  depot  requisitions  and 
priced  invoices  are  issued  from  the  stock  already  purchased  by  the  Bureau  of 
Medicine  and  Surgery.  The  fulflUment  of  such  requisitions,  therefore,  requires 
no  action  on  the  part  of  the  Bureau  of  Supplies  and  Accounts. 

Section  9. — Miscellaneous  Supplies. 

3421.  Certain  equipment  of  the  Medical  Department  aboard  ship,  like  operat- 
ing-room furniture,  bunk  frames,  splint  stretchers,  mattresses,  etc.,  is  fur- 
nished by  the  Bureau  of  Construction  and  Repair,  and  requisitions  pertaining 
to  these  articles  should  be  drawn  accordingly.  Requisitions  for  electrical  ap- 
paratus not  strictly  medical  go  to  the  Bureau  of  Steam  Engineering. 

3422.  Upon  requisition  by  the  medical  officer,  the  commanding  officer  of  the 
ship  will  authorize  the  pay  officer  to  pay  for  any  articles  of  special  diet  ob- 
tained for  the  sick  from  wardroom  or  other  mess  on  shipboard.  When  a  patient 
is  wholly  subsisted  in  this  manner  the  pay  officer  will  check  the  mess  rations 
on  the  pay  roll. 

Section  10. — Laws  and  Decisions  Relating  to  Funeeal  Expiinses. 

3431.  Funeral  expenses.  Sec.  1587,  R.  S. ;  acts  of  May  13,  1908;  Aug.  29, 
1916 ;  June  15,  1917. 

3432.  Deaths  and  desertions.    Sec.  1624,  R.  S.,  art.  20,  A.  G.  N. 

3433.  Transportation  and  burial  of  the  dead  (Navy).  Annual  appropriation 
act  (contingent,  Medicine  and  Surgery). 

3434.  Funeral  expenses  of  marines,  including  the  transportation  of  bodies 
from  the  place  of  demise  to  the  homes  of  the  deceased  in  the  United  States. 
Annual  naval  appropriation  act  (contingent,  Marine  Corps). 

3435.  Transportation  of  remains  (special  appropriations).  Naval  appro- 
priation acts  approved  Apr.  27,  1904,  Mar.  3,  1905,  May  13,  1908,  Aug.  29,  1916, 
June  15,  1917.  ^  .       ,.        . 

3436.  (o)  Funeral  expenses  of  an  enlisted  man  of  the  Navy  who  dies  at  a 
naval  hospital  and  is  buried  by  naval  authorities,  defrayed  by  Government. 
(b)  If  funeral  taken  charge  of  by  relatives,  expenses  not  chargeable  to  Govern- 
ment.   Ruling,  Comptroller's  Office,  Mar.  19,  1901. 

3437.  Disinterring  and  transporting  of  remains.  Ruling,  Comptrollers 
Office,  Apr.  8,  1902.  ^   ,.  ^        .    „     , 

3438.  Burial  expenses  of  enlisted  men  of  the  Navy.  Rulings,  Comptrollers 
Office,  July  5,  1902,  Aug.  5,  1916, 

3439.  Transportation  of  remains  allowed  where  home  is  not  in  United 
States.    Ruling,  Comptroller's  Office,  Nov.  10,  1902. 

3440.  Shipment  of  remains  of  officers  who  die  at  sea  chargeable  to  appro- 
priation "  Bringing  home  remains  of  officers  and  men.  Navy  and  Marine  Corps, 
who  die  abroad."    Ruling,  Comptroller's  Office,  Apr.  7,  1903. 

3441.  No  funeral  expenses  may  be  allowed  for  an  officer  who  dies  in  Hawaii, 
as  it  is  not  a  foreign  country.    Ruling,  Comptroller's  Office,  Dec.  14,  1903, 

3442.  Public  transportation  of  deceased  marines  to  homes  in  the  United 
States  authorized.    Ruling,  Comptroller's  Office,  Mar,  7,  1904, 

3443.  Reimbursement  of  expenses  for  disinterring  and  transporting  to  then- 
homes  the  remains  of  enlisted  men  who  die  within  the  continental  limits  of  the 
United  States  is  authorized.    Ruling,  Comptroller's  Office,  Aug.  3,  1904. 

3444.  Under  urgent  deficiency  act,  June  15,  1917,  funeral  expenses  of  officers 
of  the  Navy  and  Marine  Corps  in  active  service  who  die  in  hospitals,  or  whose 
remains  may  be  transferred  thereto,  may  be  defrayed  as  a  charge  against  the 
appropriation  "  Contingent,  M.  and  S.,  1917-1918,"  during  the  period  for  which 
the  appropriation  is  made.  This  enactment  was  secured  to  meet  the  emergency 
of  war.  It  does  not,  primarily,  annul  section  1587  of  the  Revised  Statutes,  but 
acts  to  suspend,  temporarily,  the  prohibition  of  that  section. 

98601°— 17 16 


242      ma:nual  ior  the  medical  department,  u.  s.  jsavy. 

Section  11. — Navy  IlEQtrLATioNs  and  Naval  InstbuctionsKet-atingto  Funkral 

EXPKNSES. 

8450.  Care  in  preparation  of  remains.    It  4551  (5-8). 

3451.  Gratuity  pay  to  designated  beneficiary.     R  4551  (1). 

3453.  Funeral  expenses  in  United  States  and  in  foreign  countries.  R  4551 
(2). 

3453.  Expenses  of  interment,  how  governed  in  varying  circumstances.  R 
4551   (3)    (4). 

3154.  Pay  for  services  of  ministers  at  burials  of  officers  may  not  be  allowed. 
(Sec.  1587,  R.  S.)  Such  services  in  the  case  of  enlisted  men  may  be  employed 
when  the  services  of  a  Navy  chaplain  are  not  available.  (Departmoiu'.s  loiter 
No.  6427-56;  M.  and  S.  No.  123665.) 

3455.  (a)  In  all  cases  where  the  shipment  of  the  remains  of  an  olHcor  or 
enlisted  man  of  the  Navy  or  Marine  Corps,  who  may  have  died  in  a  naval  hos- 
pital, is  requested  by  the  next  of  kin,  this  request  shall  be  made  to  tlie  Bureau 
of  Medicine  and  Surgery  by  telegram ;  all  shipments  authorizerl  will  be  on  two 
first-class  tickets  or  on  Government  bills  of  lading,  prepaid.  In  the  case  of  an 
officer  or  enlisted  man  of  the  Navy  bills  for  the  shipment  of  remains  will  be  a 
charge  against  the  appropriation  "  Bringing  home  remains  of  officers  and  men, 
Navy  and  Marine  Corps,  who  die  abroad."  In  the  case  of  an  officei*  or  enlisted 
man  of  the  Marine  Corps,  bills  for  the  shipment  of  remains  will  be  a  charge 
against  "  Contingent,  Marine  Corps,"  and  will  be  forwarded  direct  to  the 
quartermaster.  United  States  Marine  Corps,  for  payment.  Under  the  Couip- 
boller's  decision  of  August  5,  1914,  expenses  of  transportation  of  remains  of 
persons  not  in  the  naval  service  can  not  be  made  a  charge  against  Government, 
except  as  prescribed  in  paragraph  3460. 

(h)  In  all  cases  where  the  wishes  of  the  kin  are  desired  with  I'espect  to  dis- 
position of  remains,  they  shall  be  instructed  by  telegraph  to  communicate  with- 
out delay  direct  with  the  Surgeon  General,  Navy  Department,  Washington, 
D.  C.    R  2119  (2). 

345C.  No  funeral  expense  of  a  naval  officer  who  dies  in  the  United  States, 
nor  expenses  for  travel  to  attend  the  funeral  of  an  officer  who  dies  there,  shall 
be  allowed.  But  when  an  officer  on  duty  dies  in  a  foreign  country  the  expenses 
of  his  funeral,  not  exceeding  his  sea  pay  for  one  month,  shall  be  defrayed  by  the 
Government  and  paid  by  the  paymaster  upon  whose  books  the  name  of  such 
officer  was  borne  for  pay.     ( Sec.  1587,  R.  S. )      ( See  3444. ) 

3457.  The  fact  that  an  officer  of  the  Navy  has  started  on  foreign  service,  hut 
died  in  a  port  of  the  United  States  at  which  his  vessel  had  touched,  does  not 
relieve  his  ease  from  the  prohibition  contained  in  section  1587  of  the  Revised 
Stafrntes: 

3458.  Undo  •  a  decision  of  the  Navy  Department,  the  allowance  of  the  funeral 
expenses  of  officers  who  die  at  sea  on  their  way  home  from  a  foreign  station  is 
not  prohibited  by  section  1587  of  the  Revised  Statutes. 

3450.  The  transportation  expenses  of  the  remains  of  officers  and  enlisted  uhmi 
who  die  on  duty  in  a  foreign  country  will  be  defrayed  fn)ra  an  appropriation 
under  the  control  of  the  Bureau  of  Medicine  and  Surgery. 

34(J0.  The  naval  appropriation  acts  contain  provisions  which  authorize  the 
Secretary  of  the  Navy,  In  his  discretion,  to  cause  to  bo  transferred  to  their 
homes  flie  remains  of  officers  and  men  of  the  Navy  and  Marine  (I'orps  wbo  <lie 
or  are  killed  in  action  ashore  or  afloat  and  the  remains  of  civilian  employees 
who  die  outside  the  continental  limits  of  the  TJnItfd  States.  The  acts  further 
provide  that  the  sums  appropriated  lor  this  jmrpose  shall  be  availnhlo  for  trans- 
portation of  the  remains  of  officers  who  have  died  while  on  duty  at  any  time 
since  April  21,  1898,  and  shall  be  available  until  used  and  applicable  to  past  ns 
well  as  future  obligations. 

8461.  Where  the  family  of  an  enlisted  man  of  the  Navy  who  dies  while  on 
leave  nolifi^'s  the  naval  authorities  of  his  deafh   (an  evident  request  for  iMiriid, 


MANUAL   FOR   THE    MEDICAL   DEPARTMEXT,    U.    S.    NAVY.         243 

but  which  was  not  so  construed  by  the  authorities),  and  then  proceeds  with 
the  funeral  at  their  own  expense,  they  may  be  allowed  reimbursement  for  the 
necessary  and  proper  funeral  expenses  when  approved  by  the  Biir(:iu  of 
Medicine  and  Surgery. 

Section  12. — Dispositioa  oi<'  the  Dead. 

3402.  When  a  death  occurs  aboard  a  sliip  hi  liome  waters  and  witliin  easy 
reach  of  a  United  States  naval  hospital,  the  body  may  be  sent  to  said  hospital 
after  due  notice,  unless  there  are  reasons  for  immediate  burial  or  shipment  else- 
where. Outside  home  waters  the  body  should  be  sent  to  a  hospital  ship,  if 
one  is  at  hand,  after  giving  due  notice  to  commanding  officer  of  the  same.  In 
all  cases  where  a  body  is  sent  away  for  shipment  or  burial,  body  should  be 
dressed  or  proper  uniform  for  burial  sent  with  it.  A  copy  of  report  (certificate 
of  death)  P'orm  N  should  accompany  body  when  tran,sf erred.    Sec.  2579. 


CHAPTER  21. 


INVOICES  AND  RECEIPTS  ;  PROPERTY  ACCOUNTABILITY ;  TRANSFER 

OP  STORES. 

Section  1. — Navy  Regulations  and  NaVai.  Instructions  Relating  to  Invoices 
AND  Receipts  of  Medical  Stoees,  Supplies,  and  Transfeb  of  Stores. 

3501.  Invoices  and  receipts.     I  2118. 

3502.  Transfer  of  stores.    I  2124 ;  I  2125 ;  I  4422. 

3503.  Medical  supplies.    R.  4623. 

3504:.  Accountability  for  property.    I  2125 ;  I  3255. 

Section  2. — General  Information. 

3511.  Medical  officers  are  required  to  make  themselves  familiar  with  the 
instructions  contained  in  the  Navy  Regulations  and  Instructions  relating  to 
medical  invoices  and  receipts,  property  accountability,  and  transfer  of  stores. 

3512.  The  medical  officer  shall  be  furnished  with  triplicate  invoices  of  all 
articles  embraced  in  his  medical  outfit  as  soon  as  the  ship  to  which  he  has  been 
assigned  has  been  placed  in  commission.  The  invoices  shall  be  signed  by  the 
medical  officer  in  command  of  the  naval  medical  supply  depot. 

3513.  Upon  the  delivery  of  the  medical  stores  the  medical  officer  shall  receipt 
for  them,  but  not  until  he  has  satisfied  himself  that  they  correspond  in  char- 
acter and  amount  to  the  specifications  of  the  invoices.  The  medical  officer 
shall  forward  the  first  to  the  medical  officer  of  the  medical  supply  depot,  tlie 
second  to  the  Bureau  of  Medicine  and  Surgery,  and  the  third  shall  be  retained 
for  the  files  of  the  medical  department  of  the  ship. 

3514.  When  medical  stores  have  been  transferred  from  a  naval  medical 
supply  depot  to  a  ship  after  the  receipt  and  proper  disposition  of  the  regular 
outfit,  they  shall  be  invoiced  and  receipted  for  in  like  manner. 

3515.  When  medical  supplies  are  transferred  from  a  medical  supply  ship, 
storeship,  storehouse,  or  depot  to  a  ship,  the  invoices  and  receipts  shall  be  made 
in  triplicate.  They  shall  be  approved  by  the  senior  officer  present  and  disposed 
of  in  the  same  manner  as  at  a  navy  yard. 

3516.  In  transferring  medical  stores  from  one  ship  in  commission  to  another 
the  invoices  and  receipts  shall  be  prepared  in  triplicate  arid  approved  by  the 
senior  officer.  Medical  officers  receiving  and  transferring  stores  shall  sign  the 
three  copies ;  the  first  shall  be  retained  by  the  medical  officer  receiving  the 
stores,  the  second  shall  be  forwarded  through  the  commanding  officer  to  the 
Bureau  of  Medicine  and  Surgery,  and  the  third  Should  be  kept  by  the  medical 
officer  transferring  the  stores. 

3517.  Should  the  medical  officer  discover  any  discrepancy,  error,  or  omission 
in  the  invoices  of  stores,  such  fact  shall  be  reported  by  him  to  the  commanding 
officer,  who  shall  cause  the  necessary  corrections  to  be  made  in  the  invoices 
before  they  are  receipted. 

3^18.  The  invoices  of  medical  stores  shall  be  placed  on  the  files  of  the 
medical  department  of  the  ship,  and  when  the  ship  is  placed  out  of  commission 
they  shall  be  transferred  with  the  medical  outfit  as  directed  by  Naval  Instruc- 
tions, article  2124. 

245 


241)        MANUAL    FOR    TIIK    MEDICAL    DEPARTMENT,    U.    S.    NAVY. 

351JK  In  all  cases  where  storets  or  inedical  supplies  are  transferred  from  the 
care  of  one  medical  officer  to  another,  triplicate  receipts  must  be  passed. 

3520.  The  instructions  contained  in  the  Navy  Ilejrulations  require  that  when- 
ever a  medical  officer  or  a  nieraher  of  the  Hospital  Corps  in  charge  of  medical 
supplies  is  relieved  from  duty  he  shall  transfer  to  his  successor  all  public 
property  under  his  charge.    I  2125 ;  I  3255. 

3521.  Medical  officers  are  requireil  by  the  regulations  to  keep  an  accurate 
account  of  the  expenditure  of  all  public  property  under  the  control  of  the 
Medical  Department  of  the  Navy. 

3522.  Medical  officers  will  forward  to  the  Bureau  of  Medicine  and  Surgery, 
with  the  retiu-n  of  property  (Form  D),  a  concise  account  of  the  authority  and 
reasons  for  expenditure  and  disposition  of  all  property  expended,  other  than 
)nedicines.  hospital  stores,  surgical  dressings  and  appliances,  and  stationery. 

3523.  They  will  uot  be  released  from  responsibility  for  the  loss  of  surgical 
instruments,  nonexpendable  supplies,  or  furniture,  unless  the  expenditure  shall 
ha\e  been  authorized  by  the  bureau  or  a  boiird  of  survey. 

3524.  The  property  return  from  ships  in  the  fleet  sh.nll  be  forwarded  through 
the  commander  in  chief  and  the  fleet  surgeon,  who  will  ascertain  whether 
or  not  expenditures  were  made  with  due  regard  to  efficiency  and  economy, 
and  will  report  to  tlie  bureau  any  instances  of  wastefulness  or  unauthorized 
expenditure. 

3525.  Issues  of  medicines  oi*  medical  stores  to  persons  other  than  those 
in  the  Navy  shall  be  noted  in  a  prescription  book  kept  for  the  purpose. 

SKCTION  3.-M3UTFITS    AND   SUPPLIES   FUENISHED   TllOU    THE   NaVAT.   MkDIOAI,    SUP- 
PLY Depots— -Na VAT,  Instrfotions  Ret.atin<5  to  the  Man-ner  op  Making  Req- 

T'TSITIOTfS. 

3531.  Requisitions  for  hospitals,  receiving  sliips.  yard*,  stations,  and  ships 
in  (ommission.     I  2119:  1  2120. 

3.'»32.  Requisitions  for  medical  supplies.     I  46.57. 

3533.  Instruments  and  medical  supplies  to  be  selected.     I  44801. 

Section  4. — Ik.strttctionr  Rei-atikg  to  the  Manner  of  Makino  Reqihsttions. 

8541.  Requisitions  for  stores  and  supi)lies  that  may  be  required  in  the  Medi- 
cal Department  of  the  Navy  .shall  be  made  (tn  the  prescribed  forms,  as  follows: 
(a)  For  hospitals,  on  the  1st  of  March  and  September, 
(61   For  ynnls  and  stations,  on  the  1st  of  Ai>ril  and  October. 

(c)  For  receiving  ships  and  ships  in  reserve.. on  the  1st  of  May  and  November. 

(d)  For  <Tuising  ships,  when  necessary  or  when  near  a  convenient  source 
of  supply. 

3542.  The  quantities  of  medicines  required  shall  correspond  in  amount  to 
ilie  packages  designated  in  the  Supply  Table,  and  the  column  "On  hand"  shall 
always  be  entered  opposite  the  articles  required. 

3543.  A  medical  officer  serving  in  a  .ship  not  attached  to  a  fleet  and  outside 
1h(  liiited  States  may  make  seiniannnal  re«|uisitions  for  medical  stores  on  the 
jiay  officer  of  the  ship. 

3544.  Indispensable  articles  not  erabracerl  in  the  Supply  Table  that  may  be 
needed  before  the  time  for  the  semiannual  requisitions,  may  be  rc(|uired  for 
whenever  such  supplies  are  deemed  necessary.  Special  requisition  (Form  4) 
slmll  be  employed  for  this  purpose,  or  reipiisitlon  Form  1.  ;.<  iirovlde<l  in  article 
?.?im. 

3545.  The  jiUownnces  In  the  Supply  Table  are  intended  as  the  basis  of 
-up|)lies  when  fltting  out  for  a  cruise.  Needful  .iddifions  may  subsequently 
be  made  from  time  to  time  by  requisitions,  liut  It  is  not  necessary  or  expect eil 
IJiut  these  additions  himii  lirins  tlw  aiuauut  on  Jumd  .fiillj  up  toOi.nt  given  in 
the  Supply  Table.  mjoo  lB'>!boin  srtl  fit!//  l»'jiT.'>r>r:  if 

T 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.   S.    NAVY.        247 

3o4G.  Requisitious  for  stores  and  supplies  shall  be  made  by  the  senior  medical 
ofiicer  to  cover  ordinary  expenditures ;  but  if  it  can  be  avoided  such  supplies 
shall  not  be  procured  by  purchase. 

3547.  When  any  of  the  supplies  and  stores  on  board  ship  in  charge  of  other 
officers  are  deemed  necessary  for  the  treatment  of  the  sick,  they  may  be  obtained 
by  the  senior  medical  officer  upon  requisition  duly  approved  by  the  commanding 
officer.    A  receipt  for  them  shall  be  given.     (I  4422.) 

.4648.  Requisitions  for  medical  supplies  from  ships  in  commission  at  navy 
yards  shall  be  made  upon  the  Bureau  of  Medicine  and  Surgery,  unless  to  supply 
some  article  for  w^hich  there  is  an  immediate  demand,  in  which  case  the  pur 
chase  shall  be  made  by  the  pay  officer  of  the  ship  upon  a  requisition  approved 
by  the  commandant.     (I  4472  {());}  4654  (6).) 

Section  5. — Instructions  Relating  to  the  Supply  Table,  Supplies  is-rom  Sup- 
ply Depots,  Supply  Ships,  and  the  Naval  Medical  School. 

3551.  (a)  The  Supply  Table  of  the  Medical  Department  is  intended  as  a 
basis  for  all  requisitions  from  hospitals,  shore  stations,  and  ships. 

(b)  The  Field  Supply  Table  is  intended  as  a  basis  for  supplying  the  needs 
of  an  expeditionary  force. 

3552.  Medical  outfits  for  ships  in  commisi^ion  on  the  Atlantic  coast  shall  be 
furnished  from  the  naval  medical  supply  depot,  Brooklyn,  N.  Y.  Medical  outfits 
and  supplies  for  ships  in  commission  on  the  Pacific  coast  shall  be  furnished 
from  the  naval  medical  supply  depot,  Mare  Island,  Cal.  Medical  outfits  and 
supplies  for  ships  on  the  Asiatic  Station  shall  be  furnished,  whenever  prac- 
ticable, from  the  naval  medical  supply  depot,  Canacao,  P.  I. 

3553.  A  supplementary  list  of  articles  (not  included  in  the  Supply  Table)  in 
store  at  the  naval  medical  supply  depots  will  be  furnished  upon  requisition  tfi 
hospitals,  stations,  and  ships.  In  making  requisitions  for  supplies  from  this  list 
medical  officers  will  use  special  requisition  Form  Ba. 

3554.  Medical  officers  attached  to  ships  fitting  out  for  foreign  stations  or 
extended  cruises  shall  submit  their  requisitions  in  ample  time  to  have  them 
filled  before  leaving  a  navy  yard. 

3555.  Microscopes  and  microscopical  outfits  will  be  supplied  upon  approved 
requisition  for  these  items  alone,  and  when  received  will  be  carried  on  the  books 
of  the  Medical  Department,  and  shall  not  be  transferred  except  by  authority  of 
the  bureau.  When  a  ship  is  placed  out  of  commission  the  microscopical  outfit 
will  be  returned  to  the  Naval  Medical  School,  as  directed  by  Naval  Instructions, 
article  2124  (1)  &. 

3556.  The  following  bacteriological  supplies  are  procurable  upon  application 
by  letter  or  telegram  to  the  Naval  Medical  School,  Washington,  D.  C. : 

Blood  stain  (in  sealed  tubes  containing  0.075  gm.,  and  methyl  alcohol,  2.o 
c.  c),  blood  serum  albumin,  culture  tubes  blood  serum,  culture  tubes  agar-agar, 
emulsion  typhoid  bacilli,  for  Widal  test. 

Section  6. — Txstkuctions  Relating  to  Vaccine  Vikus,  Typhoid  Prophylactic, 

and  Other  Sera. 

3561.  All  vaccine  virus  that  may  be  required  is  furnished  upon  request  by 
letter  or  telegram  addressed  direct  to  the  bureau,  or  to  the  supply  depots  at 
Mare  Island,  Cal.,  and  Canacao,  P.  I.,  for  the  Atlantic.  Pacific,  and  Asiatic 
St:itions,  respectively. 

3562.  Typhoid  prophylactic  and  other  sera  that  may  be  required  will  be 
furnished  upon  request  by  letter  or  telegram  addressed  to  the  bureau. 

3563.  Receipts  are  forwarded  to  all  medical  officers  furnished  with  vaccine 
virus,  typhoid  prophylactic,  sera,  and  antitoxins.  They  should  be  signed  by  the 
medical  officer  receiving  the  articles.  The  original  shall  be  returned  to  the 
bureau  for  its  files,  and  other  copies  disposed  of  as  indicated  on  thp  forms. 


CHAPTER  22. 


THE  NAVAL  HOSPITAL  TUND. 

Section   1. — Laws   and   Regtjlations   Relating   to   its   Establishment   and 

Administration. 

3601.  Power  to  receive  gifts  in  aid  of  marine  hospitals.     Sec.  4801,  K.  S. 

3602.  Deduction  from  pay  of  officers,  seamen,  and  marines  for  naval  hospital 
fund.     Sec.  4808,  R.  S. 

3603.  Appropriation  of  fines  imposed  by  sentence  of  courts-martial.  Sec. 
4809.  R.  S. 

3604.  Allowance  of  rations  to  naval  hospitals.    Sec.  4812,  R.  S. 

3605.  Allowance  from  pensions.    Sec.  4813,  R.  S. 

3606.  Deductions  for  hospitals  from  pay  of  officers  and  enlisted  men  of  the 
Marine  Corps.    Sec.  1614,  R.  S. 

3607.  First  annual  appropriation  by  Congress  for  the  support  of  the  naval 
hospital  fund.    Act  May  4,  1878. 

3608.  Pension  of  seamen,  etc.,  at  naval  hospitals.  How  paid.  Act  March  3, 
1899,  amending  section  4818,  R.  S. 

3609.  Hospital  fund.  Credit  for  desertion  forfeitures.  Naval  appropriation 
act,  June  7,  1900. 

3610.  Superintendence  of  naval  hospitals.     Sec.  4807,  R.  S. 

3611.  Payments  from  fines  and  forfeitures  for  transportation  of  discharged 
prisoners.    Act  March  3,  1909. 

3612.  Sites  for  hospitals  and  extensions  to  hospitals  to  be  authorized  by 
Congress.    Act  March  4,  1913. 

3613.  Proceeds  of  sale  of  hospital  property  revert  to  the  hospital  fund. 

3614.  Payments  from  navy-yard  employees  for  subsistence  in  hospital.  Gen- 
eral Order  No.  148,  January  10,  1912. 

Section  2. — Navy  Regulations  Relating  to  the  Naval  Hospital  Fund. 

3621.  Deductions  from  pay  of  officers,  seamen,  and  marines  for  hospital  fund. 
R  4404. 

3622.  Deduction  of  value  of  rations  from  accounts  of  persons  in  hospitals. 
R4521. 

3623.  Pensions  of  pensioners  and  supernumeraries  in  hospital.    R  4533. 

3624.  Deduction  from  pay  of  nurses  for  hospital  fund.     R  4428  (5). 

3625.  Deduction  from  pay  of  officers  and  men  of  the  Naval  Auxiliary  Service 
for  hospital  fund.     (See  "Regulations  foi  the  Naval  Auxiliary  Service.") 

Section  3. — Information  Relating  to  the  Origin  and  Uses  of  the  Naval 

Hospital  Fund. 

3631.  On  July  16,  1798,  Congress  enacted  a  law  making  suitable  provision  for 
the  relief  of  sick  and  disabled  seamen.  The  law  went  into  effect  on  September 
1,  1798.  The  first  section  provided  that  the  master  or  owner  of  every  ship  or 
vessel  of  the  United  States  arriving  from  a  foreign  port  should  render  to  the 
collector  of  the  port  a  true  account  of  the  number  of  seamen  employetl  on  board 
such  vessel,  and  should  pay  to  the  said  collector  at  the  rate  of  20  cents  per 
month  for  every  seaman  so  employed ;  v»'hich  sum  he  was  authorized  to  retain 
out  of  the  wages  of  such  seamen. 

3632.  Out  of  this  fund  the  President  of  the  United  States  was  authorized  to 
provide  for  the  temporary  relief  and  maintenance  of  sick  and  disabled  seamen 

249 


250        MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVV. 

in  the  hospitals  or  other  institutions  then  existing  in  tlie  several  ports  of  the 
United  States. 

3G33.  The  President  was  also  authorized  under  the  provisions  of  this  act  to 
receive  donations  of  real  or  personal  property  in  the  name  of  the  United  States 
for  the  erection  or  support  of  hospitals  for  sick  and  disabled  seamen. 

3634.  Under  the  same  act  the  President  was  granted  the  necessary  authority 
to  appoint  persons  to  be  called  directors  of  the  marine  hospitals  in  the  different 
ports  of  the  United  States,  who  were  intrusted  with  their  direction  and  super- 
visory control, 

3635.  The  objects  and  resources  of  this  fund,  known  as  the  "  Marine  hos- 
pital fund,"  as  provided  by  the  law  July  16,  1798,  were  considerably  enlarged  by 
11)0  act  of  March  2,  1799,  which  gave  the  Secretary  of  the  Navy  the  necessary 
uuUiorlty  to  deduct,  after  the  first  day  of  September,  1799,  from  the  pay  of  the 
oflicers,  seamen,  and  marines  in  the  Navy  of  the  United  States  at  the  rate  of 
20  cents  per  month  and  to  pay  the  same  quarterannually  to  the  Secretary  of 
the  Treasury.  It  was  further  directed  that  the  money  so  collected  should  be 
applied  to  the  same  purposes  as  the  money  collected  by  virtue  of  the  act  of  July 
16,  1798,  and  that  it  be  expended  in  like  manner  under  the  direction  of  the 
President  of  the  United  States. 

3636.  By  the  passage  of  this  act  (Mar.  2,  1799)  the  officers,  seamen,  and 
marines  of  the  Navy  of  the  United  States  were  entitled  to  receive  the  same 
benefits  and  advantages  as  were  provided  by  the  law  of  July  16,  1798,  for  the 
relief  of  the  sick  and  disabled  seamen  of  the  merchant  vessels  of  the  United 
States. 

SiisV.  On  January  16,  1811,  the  marine  hospital  fund  amounted  to  .$73,288.38. 
and  of  this  amount  $55,649.29  had  been  deducted  from  the  pay  of  the  officers, 
seamen,  and  marines  of  the  Navy. 

3688.  Under  the  provisions  of  the  acts  of  July  16,  1798,  and  March  2,  1799. 
the  marine  hospital  fund  was  applicable  for  the  relief  of  merchant  seamen  and 
of  officers,  seamen,  and  marines  of  the  Navy. 

3639.  The  inconvenience  and  embarrassments  which  ai-ose  from  the  treat- 
ment of  patients  in  the  public  service  controlled  by  military  law  in  civil  hos- 
pitals, where  no  such  restriction  existed,  were  a  source  of  much  concern  to  tlu> 
Navy  Department,  and  the  attention  of  Congress  was  called  to  the  propriety  of 
establishing  by  law  separate  institutions  for  the  care  and  treatment  of  the  sick 
of  the  Navy. 

3640.  To  remedy  the  evils  resulting  from  the  joint  use  of  a  fund,  which  up 
to  this  period  had"  been  employed  for  the  relief  of  the  sick  of  the  merchant 
service,  as  well  as  those  of  the  Navy  and  Marine  Corps,  Congress  enacttxl  a  law 
approved  February  26,  1811,  which  provided  for  the  establishment  of  naval 
hospitals.  The  act  contained  a  clause  which  directed  that  $50,000  be  appro- 
priated out  of  the  unexpended  balance  of  the  marine  hospital  fund,  and  that  this 
sum  be  paid  to  the  commissioners  of  Navy  hospitals  for  the  purpose  of  a  naval 
hospital  fund.  The  naval  hospiti^l  fund  therefore  dates  its  origin  from  Oio 
passage  of  this  law,  February  26,  1811.  The  same  act  contained  a  further  pro 
vision  designating  the  Secretary  of  the  Navy,  the  Secretary  of  the  Treasurj-, 
and  the  Secretary  of  War  as  a  board  of  conmiissioners,  to  be  known  as  the 
"  commissioners  of  Navy  hospital.s." 

3641.  In  this  act  (Feb.  2G,  1811),  providing  for  the  purchase  of  suitable  sites 
and  the  erection  thereon  of  suitable  hospital  buildings,  Congress  specified  /hat 
all  expenditures  for  such  purposes  should  be  defrayed  from  the  naval  hospital 
futid, 

8642.  For  almost  20  years  fi'oni  the  date  of  the  act  establishing  naval  hos- 
pitals the  commissioners  of  Navy  hospitals,  owing  to  lack  of  adequate  means, 
wore  unable  to  carry  into  effect  the  provisions  thereof. 

3648.  For  many  years  after  the  e.stablishnient  of  the  naval  hospital  fund  thi> 
money  aecrtiing  to  "such  fund  was  Illegally  expended  for  other  purposes,  the 
gi-eater  portion  of  which  was  utilized  In  meeting  the  expenditures  iindor  the 
appropriation  "  Pny  of  the  Navy."  ■•••"  ^^^^  i^.-^i  iiiiiui4i.:iuj  ..  i.j 


MANUAL  FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVV.         251 

3(>14.  Ill  1S32  the  naval  liospitfil  fuucl  w;is  in  such  a  condition  jis  t<>  lie  avail- 
able to  carry  into  effect  the  wise  and  beneflcent  system  contemplated  by  the  act 
of  Fehruarj'"  26,  1811,  establishing  naval  liospitals. 

3645.  For  the  erection  of  such  hospitals,  therefore.  Congress  by  the  net  of 
July  10,  1832,  appropriated  certain  specific  sums  from  the  naval  hospital  fund, 
and  directed  the  Secretary  of  the  Navy  to  cause  to  be  constructed  for  the  use 
of  the  Navy  proper  hospitals  at  or  near  the  navy  yards  of  Charlestown,  Mass., 
Brooklyn,  N.  Y.,  and  Pensacola,  Fla.  Congress  further  authorized  the  erection 
and  completion  of  the  Naval  Asylum  (Home)  at  Philadelphia,  Pa.,  the  ex- 
penses for  such  work  being  defrayed  in  part  from  the  naval  hospital  fund. 
As  the  amounts  credited  to  this  fund  have  not  always  been  sufficient  at  all 
times  for  the  purposes  for  which  established,  Congress  has  come  to  the  relief 
of  the  fund  by  making  specific  appropriations  for  the  erection  and  completion 
of  several  hospital  establishments  which  have  subsequently  been  constructed 
in  meeting  the  requirements  and  development  of  the  naval  service. 

Section  4. — Continuous  Soueces  of  Revenue  to  the  Naval  Hospital  Fund. 

3651.  By  the  act  of  Mai-ch  2,  1799,  section  1614,  Revised  Slatutes,  the  Secre- 
tary of  the  Navy  was  authorized  and  directed  to  deduct,  after  the  1st  day  of 
September,  1799",  from  the  pay  thereafter  to  become  due,  at  the  rate  of  20 
cents  per  month  for  each  officer,  seaman,  and  maiine.  Such  deductions  are 
made  by  the  pay  officers  of  the  Navy  and  Marine  Corps  having  charge  of  the 
pay  accounts  of  the  officers,  seamen,  and  marines.  The  amounts  so  collected 
are  transmitted  quarterly  to  the  Auditor  for  the  Navy  Department,  and  by 
him  placed  to  the  credit  of  the  naval  hospital  fund. 

3652.  Section  4812.  Revised  Statutes,  act  of  February  2fi,  181 1,  provides  that 
for  every  naval  officer,  seaman,  or  marine  admitted  into  a  naval  hospital  the 
institution  shall  be  allowed  one  i-ation  per  day  during  the  period  that  ho 
remains  under  treatment  in  the  hospital.  The  value  of  such  ration  is  debited 
again.st  "  Provisions,  Navy."  and  credited  to  the  "  Naval  hospital  fund."  The 
commutation  price  of  the  ration  is  fixed  by  section  1585,  Revised  Statutes,  at 
30  cents,  and  commuted  rations  stopped  on  account  of  sick  in  hospital  are 
credited  at  the  rate  of  50  cents  per  ration  to  the  naval  ho.spital  fund  by  au- 
thority of  the  naval  act  of  June  30,  1914,  (See  comptroller's  decisions  of  Aug. 
4  and  Oct.  28.  1914.)  The  provision  of  section  4812,  Revised  Statiites.  is  now 
extended  to  members  of  the  Nurse  Corps  and  to  officers  and  men  of  the  Naval 
Auxiliary  Service. 

3<.53.  Section  4813,  Revised  Statutes,  act  of  February  26,  1811,  provides  that 
the  pensions  of  all  officei-s,  seamen,  and  marines  while  undergoing  treatment 
in  a  naval  hospital  shall  be  deducted  from  the  accounts  of  such  pensioners, 
and  shall  be  paid  to  the  Secretary  of  the  Navy,  and  credited  to  the  naval 
hospital  fund.  The  pension  agent  in  whose  district  such  pensions  are  paid 
transmits  the  sum  due  each  oflicer.  .seaman,  and  marine  during  the  time  he 
remains  under  treatment  in  the  hospital  to  the  pay  officers  on  whose  books  such 
accounts  are  carried,  to  be  by  them  transmitted  to  the  Auditor  for  the  Navy 
Department. 

3654.  Section  4809,  Revised  Statutes,  acts  February  26,  1811,  and  July  10. 
1832,  provide  that  all  fines  imposed  on  naval  officers,  seamen,  and  marines  (by 
sentence  of  court-martial)  shall  be  paid  to  the  Secretary  of  the  Navy  for  the 
ms^intenance  of  naval  hospitals.  All  credits  to  the  naval  hospital  fund  from 
this  source  are  adjusted  in  the  oflice  of  the  Auditor  for  the  Navy  Department. 

3656.  The  first  annual  appropriation  ($50,000)  for  the  support  of  the  naval 
hospital  fund  was  provided  by  Congress  under  the  act  approved  May  4,  1878. 
Between  that  date  and  1908  Congress  annually  appropriated  a  sum  varying  in 
amount.     Since  the  later  date  no  appropriation  has  been  made. 

3(i57.  The  naval  appropriation  act  approved  June  7,  1900,  provitles  that  from 
and  after  the  1st  day  of  July,  1900,  all  forfeitures  on  account  of  desertion 
shall  he  passed  to  Ihe  creilit  of  the  iiaval  hospital  fund.  Such  credits  are  ad- 
.aollBfiqonqqi!  v,o  'Mmtv  a  aiii>i  ^"^  1^^== 


252        MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

lusted  in  the  office  of  the  Auditor  for  the  Navy  Department.     All  payments 
"from  navy  yard  employees  for  subsistence  while  in  hospital  pass  to  the  hospital 

3658.  The  act  of  March  3,  1909,  provided  that  the  receipts  from  fines  and 
forfeitures  imposed  by  naval  courts-martial  be  made  applicable  for  payment  for 
transportation  of  discharged  prisoners  to  their  homes,  the  balance  not  required 
for  such  payments  to  be  transferred  to  the  naval  hospital  fund. 

365J).  Section  4810,  Ilevlsed  Statutes,  was  amended  by  act  of  March  4,  1913, 
to  read  as  follows : 

"  Sec.  4810.  The  Secretary  of  the  Navy  shall  procure  at  suitable  places  proper 
sites  for  naval  hospitals,  and  if  the  necessary  buildings  are  not  procured  with 
the  site,  shall  cause  such  to  be  erected,  having  due  regard  to  economy,  and  pref- 
erence to  such  plans  as  with  the  most  convenience  and  least  cost  will  admit  of 
subsequent  additions,  when  the  funds  permit  and  circumstances  require,  and 
shall  provide  at  one  of  the  establishments  a  permanent  asylum  for  disabled 
and  decrepit  naval  officers,  seamen,  and  marines:  Provided,  That  hereafter  no 
sites  shall  be  procured  or  hospital  buildings  erected  or  extensions  to  existing 
hospitals  made  unless  hereafter  authorized  by  Congress."  (Naval  appropriation 
act,  Mar.  4,  1913.) 

Section  5.— Specific  Sources  of  Revenue  to  the  Naval  Hospital  Fund. 

3661.  The  first  specific  appropriation  for  the  naval  hospital  fund  dates  from 
the  act  of  February  26,  1811,  providing  for  the  estalilishment  of  naval  hospitals, 
when  Congress  appropriated  for  the  purpose  $50,000  from  the  marine  hospital 

3662.  By  the  act  of  March  3,  1855,  section  6.  10  acres  of  the  land  belonging 
to  the  naval  hospitnl,  Chelsea,  Mass.,  were  set  aside  by  Congress  for  the  use  of 
the  marine  hospital  of  the  district  of  Boston  and  Charlestown.  Several  years 
after  the  passage  of  this  law  Congress,  by  an  act  approved  June  12,  1858, 
directed  that  the  value  of  the  land  that  belonged  to  the  naval  hospital  at 
Chelsea,  Mass.,  and  that  had  been  ceded  to  the  Treasury  Department  for  the 
purposes  of  a  marine  hospital,  should  be  ascertaine<l  and  that  the  sum  fixed 
upon  should  be  credited  to  the  naval  hospital  fimd. 

The  value  of  the  land  was  appraised  at  $",0,000.  and  this  amount  was  accord- 
ingly placed  to  the  credit  of  the  naval  hospital  fund. 

3663.  Ky  an  act  approved  July  2,  1890,  Congress  authorized  the  sale  and 
transfer  to"  the  city  of  Brooklyn  of  land  belonging  to  the  United  States  Naval 
Hospital,  Brooklyn.  A  clause  in  this  act  directed  that  the  value  of  the  land  so 
ceded  should  be  fixed  and  deterniined  by  a  hoard  of  throe  appraisers  to  be 
appointed  bv  the  Secretary  of  the  Navy.  The  board,  whose  report  was  approved 
by  the  Secretary  of  the  Navy,  appraised  the  land  at  .$92,000.  which  amount  was 
paid  into  the  Treasury  by  tiie  city  of  Brooklyn  and  was  placed  to  the  credit  of 
the  naval  hospital  fund. 

Section  6. — Ob.jects  of  Expendituke  FROit  the  Naval  Hospital  Fund. 
3671.  The  obiect.=?  for  which  expenditures  may  be  made  comprehend  the  pur- 
chase of  hospital  sites,  the  erection  of  hospital  buildings,  building  of  roads. 
wharve.s,  fences,  extension  of  buildings,  and  all  expenses  of  maintenance  and 
upkcHp.  including  prtnisious  and  other  supplies,  equipment,  furniture,  fuel,  light, 
minor  and  major  repairs,  and  for  the  support  of  patients  in  civil  hospitals  at 
home  and  abroad.  lOvery  expense  for  the  pi-oT)er  establishment  and  maintenance 
of  u  naval  hospital  may  be  paid  from  the  naval  hospital  fund,  except  as  Congress 
may  assume  to  provide  for  certain  expenses  by  sp(>cific  appropriation,  as.  for 
instance,  under  "Medical  Department."  tor  the  pay  of  civil  employees,  and 
under  "  Contingent  "  for  the  purchase  of  ami  feed  for  horses  and  cows  and  the 
purchase  of  autom<)t)ile  ambulances.  Specific  jtrovision  in  an  appropriation  act 
eatopR  the  naval  hospital  fund  for  the  same  purpo.se,  so  that  an  ambulance  that 
could  be  purchased  from  the  fund.  If  not  jirovided  In  the  appropriation,  can 
not  be  purchased  .'^o  long  as  provision  is  maile  by  appropriation. 


CHAPTER  23. 


THE  NAVY  PENSION  FUND  AND  GENERAL  PENSIONS. 

Section  1. — Laws  Relating  to  the  Navy  Pension  Fund. 

3701.  Secretary  of  the  Navy  trustee  of  Navy  pension  fund.    Sec.  4750,  R.  S. 

3702.  Penalties,  how  to  be  sued  for,  etc.    Sec.  4751,  R.  S. 

3703.  Navy  pension  fund,  how  to  be  invested.    Sec.  4753,  R.  S. 

3704.  Rate  of  interest  on  Navy  pension  fund.    Sec.  4754,  R.  S. 

3705.  Navy  pensions  payable  from  fund.    Sec.  4755,  R.  S. 

3706.  Half  rating  of  disabled  enlisted  persons  .serving  20  years  in  Navy  or 
Marine  Corps.     Sec.  4756,  R.  S.,  amended  by  act  of  December  23,  1886. 

3707.  Serving  not  less  than  10  years,  may  receive  what  aid.  Sec.  4757,  R.  S., 
amended  by  act  of  December  23,  1886. 

3708.  Deposit  of  collections  for  depredations.    Act  April  30,  1878. 

Section  2. — Laws  Relating  to  Pensions  and  to  the  Origin  of  Disability  ob 
Cause  of  Death,  in  Relation  to  Pesions. 

3711.  Pensions  to  officers  and  seamen  of  the  Navy  disabled  prior  to  March 
4,  1861.     Sec.  4728,  R.  S. 

3712.  I'ensions  to  widows  and  minors  of  some  officers  and  seamen  of  the 
Navy  disabled  prior  to  March  4,  1861.    Sec.  4729,  R.  S. 

3713.  Provisions  of  former  acts  extended.     Sec.  4712,  R.  S. 

3714.  Commencement  of  anterebellion  pensions.    Sec.  4713,  R.  S. 

3715.  Mexican  War  veterans.  Sec.  4730,  R.  S. ;  restoration  of  pension  in 
certain  cases.  Acts  June  9,  1880;  January  29,  1887;  June  6,  1898;  April  23, 
1900;  March  3,  1903;  May  11,  1912. 

3716.  Pensions  allowed  at  age  of  62  for  service  in  Civil  and  Mexican  wars. 
Act  of  February  6,  1907.  Provision  extended  to  certain  classes  of  beneficiaries. 
Act  of  March  4,  1907. 

Section  3. — Laws  Relating  to  Pension  fob  Disability  Contracted  in  the 

Line  of  Duty. 

3721.  "Who  are  entitled  to  pensions.     Sec.  4692,  R.  S. 

3722.  Beneficiaries  under  preceding  section.    Sec.  4693,  R.  S. 

3723.  Coast  Guard  to  cooperate  with  the  Navy.    Sec.  2757,  R.  S, 

3724.  Pensions  to  officers,  etc.,  Coast  Guard.    Sec.  4741,  R.  S. 

3725.  Pen.«ions  for  T»hvsical  disability  of  Medical  Reserve  Corps.  Act  April 
23,  1908;  act  August  22,  1912. 

3726.  Organized  Militia ;  pension  for  wounds  or  disabilities  received  or  in- 
curred in  service.     Act  Jan.  23,  1903.  " 

3727.  United  States  Auxiliary  Naval  Force.    Act  May  26,  1898. 

3728.  Limitation  in  cases  of  disability  incurred  since  July  27,  1868.  Sec. 
4694,   R.   S. 

3720.  Sick  leave,  sick  furlough,  veteran  furlough,  line  of  duty.  Sec 
4700,  R.    S. 

3730.  Rate  of  pension  for  total  disability  according  to  rank.    Sec.  4695,  R.  S. 

3731.  Relative  rank  in  the  Navy.    Acts  March  3,  1877;  June  18,  1878. 

258 


254        MANUAL   FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

lllU'Z.  Kate  of  peusion  dependent  on  rank  wlien  disability  origluatetl.  Sec. 
4096,   R.   S. 

3733.  Honorably  discharged  men  serving  90  days  during  War  of  the  Rebel- 
lion, disability  not  results  of  own  vicious  habits.  Acts  June  28.  1906,  June  27, 
1S90,  May  9,  1900,  July  1,  1902,  May  11,  1912,  August  22,  1912. 

3734.  I{ato  of  specific  disabilities  prior  to  June  4,  1872.    Sec.  4697,  R.  S. 

3735.  Kate  for  permanent  specific  disabilities  since  June  4,  1872.  Sec.  4698, 
li.  S. ;  acts  June  18,  1874,  June  16,  1880,  June  17,  1878,  March  3,  1879,  April  8, 
1904,  February  12,  1889,  February  28,  1877,  June  18,  1874,  March  3,  1883,  March 
3,  1885,  August  4,  1886,  March  2,  1903,  August  27,  1888,  January  15,  1903, 
March  4,  1890,  July  14,  1892. 

3736.  Soundness  of  soldier  or  sailor  at  enlistment  to  be  presumed;  but  may 
be  rebutted.     Act  of  March  3,  1885. 

3737.  Merchant  marine  service;  persons  serving  therein  liable  to  draft  in 
time  of  war  and  entitled  to  pensions  for  wounds  received.     Act  May  28,  1896. 

Section  4, — Pensions  to  Widows  and  Dependent  Relatives  Based  on  Sekvice 

SiNCji  Mauch  4,  1861. 

3741.  Widows  and  minors,  when  eutltlai,,,  ,Se«s.  4702,  4703,  R.  S.;  acts  June 
27,  1890,  May  9,  1900,  April  19,  1908.  ,...;.  ' 

3742.  Pensions  to  dependent  relatives.,  Sec,  470Y,  R.  S. ;  act  June  27,  1890. 

3743.  Date  of  death  fixed  in  case  of  officers,  etc.,  lost  in  wreck  of  steamer 
Jeannette.    Act  January  3,  1887. 

3744.  One  year's  pay  given  to  widows,  etc.,  of  those  lost  in  wreck  of  Ashue- 
lot;  to  be  deducted  from  any  pension  allowed.    Act  January  29,  1887. 

3745.  Connnencement  of  pensions  arising  out  of  destruction  of  Maine.  Act 
March  30,  1898. 

Section  5. — Jnavy  Regui^ations  Relating  to  Pensions. 

3761.  Commanding  officer  to  sign  descriptive  list  on  certificates  of  pension. 
R  2120. 

3752.  Pension  of  pensioner  in  a  naval  hospital.    R  4533. 

3753.  Service  pension  to  disabled  after  10  years'  service.    R  4.561  (1). 

3754.  Pension  after  20  years'  service.    R  4561  (2). 

3765.  Evidence  of  claim  for  pension  on  official  report  of  death.     R  4562. 

3  7 66.  Accidents  in  absence  of  a  medical  olficer,  eyewitnesses  to  report  upou. 
R  4.563. 

3767.  If  record  is  incomplete  the  bureau  is  to  decide  line  of  duty.    R  4564. 

3768.  Medical  officers  at  navy  yards  to  examine  applicants  for  pension  under 
sections  4756  and  4757,  Revised  Statutes,  and  give  required  certificates.  I 
3461  (3). 

3759.  Correspondence  relating  to  pensions  to  be  direct  with  Pension  Bureau, 
r  5309. 

Skction    6. — General    Infobmation    Reoardino    Pensions    and    Pension 

Legislation. 

3761.  In  making  entries  on  medical  records  great  care  shall  always  be  taken 
by  medical  officers  in  stating  the  degree  of  disability  and  to  describe  its  extent, 
nature,  and  location.  Great  care  sliould  also  be  taken  to  avoi<l  any  basis  for 
conlllct  of  opinion  between  the  original  record  of  disability  and  the  findings  of  a 
hoanl  of  survey  as  to  whether  the  disability  was  or  was  not  in  the  lino  of  duty. 

8762.  Tl»e  Navy  pension  fund  dates  its  origin  from  March  2,  1799,  when 
L'ungress  enacted  a  law  providing  (hat  every  officer,  seaman,  or  marine  disabled 
in  the  line  of  duty  should  be  eutitlcil  to  i-eceive  for  his  own  life,  and  the  life  of 
his  wife,  if  a  njarrletl  man  at  the  linje  of  receiving  the  wound,  one-half  of  his 
niontlily  paj'. 


MANUAL   run    THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.        255 

3  J  60.  '.riie  same  act  iiirtlier  provided  that  all  mouey  accruing  or  which  had 
accrued  from  the  sale  of  prizes  should  be,  and  remain  forever  a  fund  for  the 
Itaynient  of  the  half  pay  to  the  officers  and  seamen  who  should  be  entitled  to 
i-eceive  the  same;  and  if  the  fund  sliould  be  insufficient  for  this  purpose,  the 
public  faith  was  pledged  to  make  up  the  deficiency ;  but  if  it  should  be  more 
than  sufficient,  the  surplus  should  be  applied  as  Congress  should  direct  to  the 
making  of  further  provision  for  the  comfort  of  disabled  officers,  seamen,  and 
marines,  and  for  such  as  might  not  be  disabled,  but  who  by  their  bravery  or 
their  long  and  faithful  services  might  merit  the  gratitude  of  their  country. 

3764.  The  acr  of  March  2,  1799,  also  provided  for  the  management  of  the 
Navy  pension  fund  by  a  commission  consisting  of  the  Secretaries  of  the  Navy, 
War,  and  Treasury,  who  were  authorized  to  receive  all  such  sums  as  the 
United  States  might  be  entitled  to  from  the  sale  of  prizes,  and  to  invest  the 
same  and  the  interest  arising  therefrom  in  such  of  the  6  per  cent  or  other  stock 
of  the  United  States  as  a  majority  of  the  commission  should  deem  most  ad- 
vantageous. The  commissioners  were  further  directed  to  lay  before  Congress 
every  yeai-,  in  the  first  week  of  its  annual  meeting,  a  minute  and  correct  state- 
ment of  tlieir  proceedings  in  relation  to  the  management  of  the  Navy  pen- 
sion fund. 

37(>5.  The  act  for  the  better  government  of  the  Navy,  approved  April  23, 
1800,  repealed  the  act  of  March  2,  1799,  although  reenacting  many  of  its 
features.  'J'he  provisions  as  to  the  management  of  the  fund  were  reenacted  with 
a  proviso  that  it  might  be  invested  in  any  manner  which  a  majority  of  the 
commissioners  might  deem  most  advantageous.  The  effect  of  this  law  repealed 
the  clause  in  the  act  of  March  2,  1799,  directing  that  the  Navy  pension  fund 
be  invested  in  6  per  cent  interest  or  other  stock, 

3700.  An  act  approved  March  26,  1804,  amended  the  act  of  March  2.  1799, 
and  directed  that  the  money  accruing  from  the  capture  of  prizes  should  be  paid 
to  the  Treasurer  of  the  United  States.  The  Treasurer  was  required  U)  disburse 
the  Navy  pension  fund  on  warrants  issued  by  the  Secretary  of  the  Navy, 
countersigned  by  the  accountant  of  the  Navy,  who  by  law  was  authorized  to 
receive  and  settle  all  accounts  relating  to  the  Navy  pension  fund.  By  the  same 
act  the  commissioners  were  authorized  and  directed  to  make  such  regulations 
as  appeared  to  them  expedient  for  the  admission  of  persons  on  the  roll  of  the 
Navy  pensioners  and  for  the  payment  of  pensions. 

.3767.  The  act  of  April  16,  1816,  provided  that  the  money  accruing  from  the 
sale  of  captured  prizes  should  be  paid  over  by  the  United  States  District  Court 
to  the  Treasurer  of  the  United  States  on  account  of  the  Navy  pension  fund. 

3768.  The  act  of  March  2,  1831,  providing  that  all  forfeitures  collected  from 
pe*-sons  depredating  upon  the  reserve  timberlands  should  be  credited  to  the 
Navy  pension  fund,  was  repealed  by  the  act  of  April  30,  1878,  which  provided 
that  all  money  derived  from  this  source  should  be  covered  into  the  Treasury  of 
the  United  States,  as  is  the  case  with  other  moneys  received  from  the  sale  of 
public  lands. 

3769.  By  the  act  of  July  10,  1832,  the  duties  of  the  commissioners  ceased,  and 
the  Secretary  of  the  Navy  was  made  the  trustee  of  the  pension  fund  and  was 
intrusted  with  the  payments  of  all  Navy  pensions  out  of  it.  By  the  same  act 
Congress  directed  that  the  fund  be  invested  in  stock  of  the  Bank  of  the  United 
States. 

3770.  The  act  of  March  2,  1832,  created  the  office  of  Commissioner  of  Pen- 
sions and  provided  that  Navy  pensions  should  be  paid  by  the  Commissioner  of 
Pensions  from  the  Navy  pension  fund  under  the  direction  of  the  Secretary  of 
the  Navy. 

3771.  By  the  act  of  March  3,  1849,  the  Department  of  the  Interior  was 
created  and  the  Pension  Office  was  transferred  to  this  department  from  the 
War  Department.  The  Pension  Office  was  transferred  from  the  Navy  Depait- 
luent  to  the  War  Department  by  the  act  of  March  3,  1835. 

3772.  The  act  of  July  7,  1862  (sec.  4752,  R.  S.),  for  the  better  government 
of  the  Navy,   reenacted   the  former  provisions  of  law  relative  to  the  money 


256        MANUAL   FOE  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

accruing  to  the  United  States  from  the  sale  of  prizes,  such  money  to  remain 
forever  a  fund  for  the  payment  of  pensions  to  officers,  seamen,  and  marines 
entitled  to  receive  them. 

S773.  The  act  of  July  1,  1864  (sec.  4753,  R.  S.),  directed  the  Secretary  of  the 
Navy,  as  trustee,  to  invest  the  Navy  pension  fund  in  repristeifecl  securities  of 
the  United  States,  and  further  directed  that  the  interest  payable  in  coin  vpas 
to  be  exchanged  for  legal  currency  of  the  United  States  and  to  be  placed  to  the 
credit  of  the  Navy  pension  fund. 

3774.  An  act  approved  July  23,  1868  (sec.  4754,  R.  S.),  known  as  the  Butler 
Act,  reduced  the  rate  of  interest  on  the  bonds  in  which  the  Navy  pension  fund 
was  invested  from  6  per  cent  in  gold  to  3  per  cent  per  annum  in  lawful  money. 

37  75.  The  report  of  the  Auditor  for  the  Navy  Department  for  the  fiscal  year 
ended  June  30,  1905,  shows  that  the  money  accruing  to  the  Navy  pension  fund 
from  the  sale  of  prizes  captured  during  the  Spanish-American  War  amounted  to 
$723  770.46. 

3776.  The  pension  fund  from  the  sale  of  prizes  amounted  on  July  23,  1868, 
to  $14,000,000,  with  an  annual  Income,  derived  from  the  interest  at  3  per  cent 
of  $420,000. 

3777.  Since  1870  the  amount  derived  from  the  interest  at  3  per  cent  on  this 
fund  has  been  inadequate  to  pay  all  Navy  pensions,  and  the  provision  of  law 
which  pletlges  the  public  faith  to  make  up  the  deficiency  has  been  brought  into 
operation  by  annual  appropriations  subsequent  to  the  above  date. 

3778.  The  average  annual  expenditure  for  Navy  pensions  for  the  past  five 
years  has  amounted  to  about  $3,950,000,  and  the  income  from  the  Navy  pension 
fund  available  for  the  payment  of  Navy  pensions  during  the  above-mentioned 
period  has  been  less  than  10  per  cent  of  the  amount  required  for  that  purpose, 
and  it  is  improbable  that  the  interest  on  the  Navy  pension  fund  will  ever  again 
be  sufficient  to  meet  such  payments. 

3779.  The  naval  appropriation  act  approved  March  12,  1870,  contained  a 
clause  which  provided  that  the  present  and  all  future  appropriations  for  the 
support  of  the  United  States  Naval  Asylum  (Home)  should  be  charged  to  and 
paid  from  the  income  of  the  Navy  pension  fund.  The  amount  appropriated  by 
Congress  annually  for  the  maintenance  of  the  home  is  about  $75.lHXt.  which 
reduces  the  interest  available  from  this  fund  for  the  annual  payment  of  Navy 
pensions  to  less  than  $400,000. 

3780.  The  interest  on  the  Navy  pension  fund  is  paid  semiannually  and  de- 
posited to  the  credit  of  the  Secretary  of  the  Navy,  as  trustee  of  the  Navy  pen- 
sion fund.  Congress  appropriates  annually  for  pensions,  embracing  Navy  pen- 
sions, and  the  Secretary  of  the  Treasury  issues  appropriation  warrants  by 
which  the  interest  on  the  pension  fund  is  carried : 

(a)  To  the  Department  of  the  Interior  pension  ledger; 

(6)  To  the  amount  appropriated  by  Congress  for  the  maintenance  of  the 

Naval  Home. 

3781.  Section  4753  of  the  Revised  Statutes  provides  that  nothing  contained 
therein  relative  to  the  investment  of  the  interest  on  tlie  Navy  pension  fund 
shall  b«'  construed  to  interfere  with  the  payment  of  Navy  pensions  imder  the 
supervision  of  the  Secretary  of  the  Interior,  as  regulated  by  law. 

8782.  The  Secretary  of  the  Navy  does  nothing  more  than  to  cause  the  proper 
entries  to  be  made  on  the  appropriation  ledger  for  the  Navy  Department,  ex- 
cept to  draw  for  the  sum  specified  by  law  for  the  support  of  the  Naval  Home. 
The  amount  for  Navy  pensions  is  drawn  by  requisition  of  the  Secretary  of  the 

8783.  Section  4755  of  the  Revised  Statutes  provides  that  Navy  pensions  shall 
be  paid  from  the  Navy  pension  fund,  but  that  no  payment  shall  be  made  there- 
from except  ui)on  appropriations  authorized  by  Congress. 

3784  Other  charges  against  the  Interest  of  the  Navy  pension  fund  are  thos« 
j.rovided  for  in  the  acta  approved  March  2.  1867,  and  Deceml)er  2.S.  1880  (sees. 
4756  and  4757,  R.  S.), 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        257 

3785.  Section  4756  of  the  Revised  Statutes,  amended  by  act  of  Decenaber  23, 
1886.  provides  that  "  There  shall  be  paid  out  of  the  Navy  pension  fund  to  every 
person  who,  from  age  or  infirmity,  is  disabled  from  sea  service,  but  who  has 
served  as  an  enlisted  person  or  as  an  appointed  petty  officer,  or  botli,  in  the 
Navy  or  Marine  Corps  for  the  period  of  20  years,  and  not  been  discharged  for 
misconduct,  in  lieu  of  being  provided  with  a  home  in  the  Naval  Asylum,  Phila- 
delphia, if  he  so  elects,  a  sum  equal  to  one-half  the  pay  of  his  rating  at  the 
time  he  was  discharged,  to  be  paid  to  him  quarterly,  under  the  direction  of  th« 
Commissioner  of  Pensions;  and  applications  for  such  pensions  shall  be  made 
to  the  Secretary  of  the  Navy,  who,  upon  being  satisfied  that  the  applicant 
comes  within  the  provisions  of  this  act,  shall  certify  the  same  to  the  Commis- 
sioner of  Pensions  and  such  certificate  shall  be  his  warrant  for  making  payment 
as  herein  authorized." 

3786.  Section  4757  of  the  Revised  Statutes,  amended  by  act  of  December  23, 
1886,  provides  that  "Every  disabled  person  who  has  served  in  the  Navy  or 
Marine  Corps  as  an  enlisted  man  or  as  an  appointed  petty  officer,  or  both, 
for  a  period  of  not  less  than  10  years,  and  not  been  discharged  for  misconduct, 
may  apply  to  the  Secretary  of  the  Navy  for  aid  from  the  surplus  income  of  tht^ 
Navy  pension  fund ;  and  the  Secretary  of  the  Navy  is  authorized  to  convene  a 
board  of  not  less  than  three  naval  officers,  one  of  whom  shall  be  a  surgeon,  to 
examine  into  the  condition  of  the  applicant,  and  to  recommend  a  suitable  amouni: 
for  his  relief  and  for  a  specified  time  and  upon  the  approval  of  such  recom- 
mendation by  the  Secretary  of  the  Navy,  and  certificate  thereof  to  the  Com- 
missioner of  Pensions,  the  amount  shall  be  paid  in  the  same  manner  as  is  pro- 
vided in  the  preceding  section  for  the  payment  to  persons  disabled  by  long 
service  in  the  Navy ;  but  no  allowance  so  made  shall  exceed  the  rate  of  a  pen- 
sion for  full  disability  corresponding  to  the  grade  of  the  applicant,  nor,  if  in 
addition  to  a  pension,  exceed  one-fourth  the  rate  of  such  pension." 

3787.  Upon  the  approval  of  the  recommendation  of  the  board  by  the  Secre- 
tary of  the  Navy,  he  shall  certify  the  same  to  the  Commissioner  of  Pensions, 
and  such  certificate  is  the  commissioner's  authority  for  making  payment  to  the 
applicant. 

3788.  Pensions  granted  under  sections  4756  and  4757  of  the  Revised  Statutes 
are  wholly  under  the  control  of  the  Secretary  of  the  Navy,  to  whom  application 
should  be  made. 

3789.  Pensions  granted  under  sections  4756  and  4757  of  the  Revised  Statutes 
commence  from  the  date  of  the  filing  of  the  application  in  the  Navy  Department. 

3790.  When  a  sailor  or  marine  is  pensioned  under  the  provisions  of  section 
4756  of  the  Revised  Statutes,  and  where  he  has  also  established  a  claim  for 
pension  under  the  general  law  for  disability  contracted  in  the  service  and  in  the 
line  of  duty,  or  under  the  act  of  June  27,  1890,  a  certificate  consolidating  such 
pensions  is  issued,  and  he  is  entitled  to  receive  the  allowance  .uraiited  under 
section  4756,  Revised  Statutes,  in  addition  to  the  pension  granted  him  by  the 
Pension  Office,  either  under  the  general  law  or  under  the  act  of  June  27,  1890. 

3791.  Whenever  the  Secretary  of  the  Navy  certifies  to  the  I'eusion  Oliice, 
under  the  provisions  of  section  4757,  Revised  Statutes,  that  a  person  who  has 
served  10  years  in  the  Navy  or  Marine  Corps  is  entitled  to  aid  from  the  surplus 
income  of  the  Navy  pension  fund,  in  addition  to  a  pension  granted  by  the  Pen- 
sion Office,  either  under  the  general  law  or  under  the  act  of  June  27,  1890,  a 
certificate  covering  both  allowances  is  issued  by  the  Pension  Office. 

3792.  Under  the  pi'ovisions  of  sections  4756  and  4757  of  tlie  Revised  Statutes 
it  is  not  necessary  for  applicants  to  prove  the  fact  of  the  incurrence  of  disabili- 
ties in  the  line  of  duty.  The  law  requires  tliem  to  show  only  that  their  record 
complies  with  the  provisions  contained  in  these  sections  us  to  the  length  of  time 
they  shall  have  served,  and  that  during  their  service  they  have  not  been  dis- 
charged for  misconduct. 

3794.  The  pension  agent,  at  the  end  of  each  quarter,  forwards  to  the  pay 
officer  of  the  home  a  check  covering  the  amount  of  the  stopped  pensions.    This 

98601°— 17 17 


258        MANUAL   FOR   THE   AIEmCAl-    DiiJ'AHToMENT,   U.    S.    >'AVy. 

chock  is  forwarded  by  the  paymaster  in  Ids  next  quarterly  returns  to  the  Au<li- 
tor  for  the  Navy  Department,  by  whom  it  is  deposited  to  the  credit  of  the  Nav\ 
pension  fund.  a".   .'   . 

3795.  If  a  pensioner  under  section  47."5G  of  the  Revised  Stat^tes,  present* 
himself  for  reenlistment  and  is  rejected,  but  his  disqualification  is  waived  by 
the  department,  his  pension  during  hi.s  enlistment  is  suspended,  but  is  re.stored 
to  him  at  the  date  of  his  discharge.  If  a  pensioner  presents  himself  for  re- 
enlistment  and  is  found  physically  qualified  for  .service,  his  pension  terminates, 
and  upon  his  discharge  from  the  service  it  is  necessary  for  him  in  order  to  re- 
obtain  pension  to  file  a  new  application,  furnishing  information  as  to  the  addi- 
tional service,  and  if  his  claim  be  allowed  the  rate  of  pension  depends  upon  hi.s 
rating  when  last  discharged.  ,     ,     .      ,       .,.  '  ; -, 

aiiU't.  A  pension  granted  luider  thie  provisioiis  of  section  4757  of  the  Revised 
Statutes,  for  a  specified  time,  terminates  upon  reenlistment 

3797.  The  act  approved  February  6,  1907,  provided  that  any  persgn  who 
sei-ved  90  days  or  more  in  the  military  or  naval  service  of  the  United  States 
during  the  late  Civil  War  or  60  days  in  the  War  with  Mexico,  and  who  has  been 
honorably  discharged  therefrom,  and  who  has  reached  the  age  of  62  years  or 
over,  shall  be  placed  upon  the  pension  roll,  and  be  entitled  to  receive  a  pension 
as  follows :  In  case  such  person  has  reached  the  age  of  62  years,  $12  per  month ; 
70  vears,  $15  per  month;  75  years  or  over,  $20  per  month:  rrovided.  That  j)en- 
sioners  who  are  62  years  of  age  or  over,  and  who  are  now  receiving  pensions 
under  existing  laws,  or  whose  claims  are  pending  in  the  Bureau  of  Pensions 
may  bv  application  to  the  Commissioner  of  Pensions  in  such  form  as  he  may 
l)re'scri"be,  receive  the  benefits  of  this  act ;  and  nothing  herein  contained  shall 
prevent  any  pensioner  or  jierson  entitled  to  u  pension  from  prosecuting  his  claim 
;ind  receiving  a  pension  under  any  other  general  or  special  act :  ProiHded,  That 
no  person  shall  receive  a  pension  under  any  other  law  at  the  same  time  or  for 
Ihe  same  j^eriod  that  he  is  receiving  a  pension  under  the  provisions  of  this  act| 
Provided  further,  That  no  person  who  is  now  receiving  or  shall  hereafter  receive 
a  greater  pension  under  any  other  general  or  special  law  than  he  would  be 
entitled  to  receive  under  the  provisions  herein  shall  be  pensionable  under  Ihis 
act. 

Section  7.— Pensioneks  in  Naval  HosprfALS  and  Methods  to  be  Employed 
IN  Effecting  the  Reversion  of  Pr.NsioN  Money  to  the  Hospital  Fund. 

8801.  The  pension  of  a  pensioner  while  In  n  naval  hospital  reverts  to  the 
hospital  fund.  Upon  the  admission,  transfer,  discharge,  or  death  of  a  pensioner, 
the  medical  ofllcer  In  command  of  the  hospital  should  notify  the  Commissionei- 
of  Pensions  direct,  giving  name  of  pensioner,  number  and  character  of  certifi- 
cate, and  In  case  of  death,  the  date  and  cause  of  death.  Whore  a  pensioner 
Is  discharged  from  a  hospital  between  quarter  days  in  whieli  the  (luarterly 
Installments  of  the  pension  become  due.  the  pension  due  the  hospital  for  the 
fraction  of  a  q\iartcr  may  be  paid  only  at  the  expiration  of  tho  quarter  and 
upon  the  receipt  of  a  voucher  from  the  pensioner  to  show  1h:it  he  is  living, 
Should  a  i)enKioiier  die  In  hospital  or  after  discharge  with  ])ension  unpaid  for 
a  period  that  he  was  in  hospital,  sjiid  unpaid  pension  Is  not  subicct  to  claim 
undor  section  4813,  Revised  Statutes  f reversion  to  hospital  fniul).  as  pension 
Rconieil  to  pensioner's  death  is  payable  only  to  his  Avidow,  or  minor  children, 
■or  as  reimbursement  on  expenditure  from  private  funds  on  account  of  his  last 
sickness  and  burial  In  ca-se  ol  InsufTicioncy  of  his  ostnte.  as  provided  by  the  n<t  of 
March  2,  1895  (28  R.  L.,  964).  In  cases  Avhere  one-half  of  pension  has  been 
made  pnvable  to  pensioner's  wife  or  tiie  guardian  of  his  children  under  the  aet 
of  Marcli  3,  IH'.W  (30  S.  T..,  1379),  only  the  one-half  of  iionsion  rrniainlng  to  the 
I^ensloner  Is  subject  to  claim  under  section  1S13,  Revised  Stnlutes.  The  peij; 
slon  cortlficate  should  be  taken  \iv  by  t]i(>  odicer  in  connnand  upon  the  pen- 
sioner's admission  to  the  hospital  nnd  retiilued  in  his  possession  while  the  poii- 


MANUAL    i<^OR    THE    MEDICAL    DEPARTMENT^    U.    S,    NAVY.        259 

sioner  remains  iu  the  hospital,  and  in  case  of  the  pensioner's  death  in  the  hos- 
pital it  should  be  transferred  to  the  Commissioner  of  Pensions  with  a  statement 
of  (late  and  cause  of  death. 

3802.  Payments  will  be  made  by  check,  drawn  upon  an  Assistant  Treasurer 
of  the  United  States,  upon  vouchers  or  certificates  of  the  medical  officer  in 
command  of  the  hospital  presented  to  the  pension  agent  on  whose  roll  the  peu- 
sioner's  name  is  inscribed,  setting  forth  the  pensioner's  name  and  certificatfr- 
number,  the  rate  and  amount  of  the  pension,  and  the  period  or  periods  covered 
by  the  pension  during  which  he  was  in  receipt  of  the  benefits  of  the  hospital,  and 
any  intervening  period  or  periods  of  absence  on  furlough  or  otherwise  by  dates 
«jf  commencement  and  termination.  Checks  are  umde  payable  to  the  medical 
officer  in  command  and  should  be  indorsed  over  to  the  pay  officer  of  the  stations. 

3808.  Cases  may  be  met  with  in  which  the  pensioner  has  two  certificates 
representing  concurrent  allowances  of  disability  pension  and  money  benefit 
from  the  Navy  pension  fund  for  20  or  10  years'  service  under  the  act  of  MarcJi 
2,  1807  (sees.  4756.  4757,  R.  S.)  Such  issues  do  not  differ  from  single  issues  in 
the  matter  of  payment  except  that  two  vouchers  are  required. 

3804.  The  vouchors  in  each  case  will  bo  i>repared  and  forwarded  by  the  pen- 
sion  agent  charged  with  the  payment,  under  instructions  to  be  given  by  the 
{,'oiiiiiiissioiier  ot  Pensions  iipon  his  receipt  on  information  of  the  pensioner's 
admission  to  the  hospital. 

3805.  Statements  of  admission  and  discharge  of  pensioners  made  to  the 
Commissioner  of  Pensions  and  other  communications  concerning  payment  of 
pensions  addressed  to  the  Commissioner  of  Pensions,  should  bear  the  words 
"Finance  Division"  in  the  lower  left-hand  corner  of  the  envelope,  and  for 
convenience  in  filing,  each  case  should  be  made  the  subject  of  a  separate  coni- 
munication  with  the  name  and  number  of  the  pension  certificate  in  eaeli  in- 
stance, for  the  purposes  of  identification. 

3806.  The  Comptroller  of  the  Treasury,  May  12,  1913,  rendered  a  decision  t" 
tJie  effect  that  the  relief  or  money  benefit  authorized  under  section  4757,  Re- 
vised Statutes,  is  not  a  pension,  nor  is  to  be  considered  in  lieu  of  pension,  and 
therefore  not  subject  to  the  provisions  of  general  pension  laws,  such  as  arc 
contained  in  section  4813,  relating  to  the  pensions  of  pensioners  while  in  a 
naval  hospital. 


CHAPTER  24. 


BLANK  FORMS. 
Section  1. — Navy  Regulations  and  Navax  Instbuctions  Relating  to  Blank 

FOBMS. 

3901.  Requisitions  for  medical  supplies  on  prescribed  forms.    I  2119  (1-5). 

3902.  Return  of  property.    I  3255. 

3903.  Transfer  of  medical  stores.    I  2118  (4-5). 

3904.  Medical  outfit  when  going  out  of  commission.    I  2124. 

3905.  Transfer  of  stores.    I  2125, 

3906.  Respousibility  for  value  of  surgical  instruments,  etc.    I  3255  (3). 

3907.  Weekly  report  of  sick.    I  3238. 

3908.  Daily  report  of  sick.     I  2107. 
8909.  Statistical  report  of  sick.    I  3254. 

3910.  Order  of  surtey.    R  3G1. 

3911.  Report  of  survey.    R  363. 

3912.  Report  of  death.    R  2963  (1-2)  ;  I  5247  (36). 

3913.  Special  diet  list.    I  3233. 

3914.  Records  of  examinations.    I  3201. 

3915.  Misconduct  reports,  admission  and  discharge.  I  5247  (G2)  ;  Gen. 
Ord.  231. 

Section  2. — Instbuctions  Relating  to  thte  Employment  of  Blan«  Fobms. 

3921.  With  the  object  of  securing  uniformity  and  accuracy  in  the  prepara- 
tion of  the  reports  and  returns  connected  vrith  the  duties  of  the  MetHeal  De- 
partment, the  bureau  has  established  certain  blank  forms  and  designated  the 
specific  purposes  for  which  such  forms  shall  be  used,  as  follows : 

3922.  The  following  table  includes  a  list  of  the  forms  issued  by  the  Bureau 
of  Medicine  and  Surgery : 

Form  B.  Requisition  and  priced  invoice. 

Form  B.  Dental. 

Form  Ba.  Special  requisition  for  articles  in  stock  but  not  on  the  supply  table. 

Form  4.  Requisition  for  supplies  from  supply  depot. 

Form  C.  Survey  of  articles  (supply  depots  only), 
,    Form  C-1.  Survey  of  articles  (supply  depots  only). 

Form  Ca.  Survey  of  articles  (all  other  places). 
I  Form  Ca-1.  Survey  of  articles   (all  other  places). 
'   Form  D.  Inventory  of  property. 

Form  Da.  Inventory  of  property  (additional  articles)    (blank). 

Form  F.  Quarterly  abstract  of  patients. 

Form  F.  Rough  (cards). 

Form  G.  Hospital  ticket. 

Form  H.  Health  record :  Gray,  enlisted  men ;  green,  officers. 

Dental  record  for  Insertion  in  Form  H. 

Form  I.  Weekly  report  of  sick  (hospitals  and  hospital  ships), 

Foi-m  K.  Statistical  report  of  sick. 

Form  K.  Report  of  dental  operations. 

Form  K2.  Report  of  casualties.  .^^r^  ,„^,. 

261 


262         MANUAL    FOi;    THK    MKUICAl.   DEFARTMENX,    U.    S."  KAVif, 

Forin  L.  Request  for  medical  survey. 
Form  M.  Report  of  medical  survey. 
Form  N.  Report  of  death. 
Form  O.  Request  for  blank  forms. 
Form  P.  Report  of  operations   (yeurly). 
Form  Q.  Clinical  charts. 

Form  S.  Ration  notice  (admission)..ir^iAHr> 
Form  T.  Ration  notice  (discharge). 

Form  V.  Quarterly  return  of  medical  stores  (supply  depots  only). 
Form  X.  Abstract  of  enlistments  (recruiting  stations). 
Form  X.  Rough  (cards).       ,''.u.-i<  ;    ,:     -•>. 
Bill  book  (hospitals). 

Binnacle  list.  , .  ...^  •    r ,  . ,.  /  .  .'  l 

Commissary  ledger. 

Hospital  Corps,  changes  in.     (N.  M.  S.  125682.) 
Hospital  Corps,  personal  memorandum. 
Hospital  Corps,  examination  report. 

Hospital  Corps,  statement  of  qualifications  prepared  when  examined.  (N.  M.  S. 
42022.) 

Hospital  Corps,  subsistence  report     (No.  88051)    (hospitals). 

Letterheads  (hospitals).  • 

Liberty  list  (ho.spitals).  •• 

Morning  report  of  sick. 

Pass  book  (hospitals).  ^ 

Register  of  dead  (hospitals).  -'• 

Register  of  patients  (hospitals).  ''■■  •" 

Special  diet  (hospitals).  •' 

Telegraph  blanks  (hospitals).  !• 

Watch  details  (hospitals).  ''• 

Requisition  Form  1.     (Original,  memorandum.)  *  ;'. 

Requisition  Form  4.     (Original,  memorandum.)  •'<> 

Bill  Form  5.     (Original,  memorandum.)* 

Bill  Form  6.     (Original,  memorandum.)*. ha-hH  <sx.ui 

Statement  of  cost  of  maintenance,  naval  hospitals. 

Funeral  expenses ;  gratuity  pay,  report  of.  Mo  e^y  tfnyf  ,r?ft« 

Misconduct  report  (admission). 

Misconduct  report  (discharge). 

SEctiqK  3.--7pETAnj:n,  IiESM?I^Tr^^l<,)^N  w  JBl/lnjk, Forms. 

3931  (1).  Form  B. — Requisition  and  priced  invoice. 

(o)  Form  B  shall  be  prepared  semiannually  and  when  necessary.  (For  hos- 
pitals on  the  1st  of  March  and  September;  for  yards  and  stjitlons  on  the  1st 
of  April  and  October;  for  receiving  ships  and  ships  In  reserve  on  the  lst;of 
May  and  November.    I  2119  (1)  ;  I  2120  (1). 

(6)  For  cruising  .ships  requisitions  shall  be  prepared  when  necessary,  but 
they  should  be  submitted,  if  practicable,  to  anticipate  delivery  when  the  shii> 
is  at  a  convenient  shipping  point  or  at  the  navy  yard  during  the  repair  period 
or  when  near  a  supply  depot.  I  2119  (2).  Timely  requisitions  for  supplies 
shall  be  made  to  cover  ordinary  expenditures,  but  they  shall  not  be  fll1o<l  by 
purchase  if  it  can  be  avoided.  F  4475;  I  4480;  T  4R.54  (6)  ;  T  4«57.  All  requi- 
sitions for  supplies  from  ships  in  the  fleet  shall  be  forwarded  through  the  com- 
mander in  chief  for  the  Inspection  of  the  fleet  surgeon.     (Fleet  Regulations.) 

(c)  This  form  shall  be  prepared  in  quadruplicate,  numbered  in  the  serie.s 
of  the  flscal  year,  and  marked  quadruplicate  first,  second,  third,  and  fourth. 

(d)  The  quantities  of  medicines  required  shall  corre.spond  In  amount  to  the 
packages  mentioned  In  the  supply  table,  and  the  columns  "on  hand"  and 
"allowance"  shall  always  be  filled  opposite  the  article  required.    I  2119  (3). 


*  BequlsltlOD  Form  1  and  Bill  FormB  6  and  B  are  for  shore  use  only. 


MANUAL   FOR   THE    MEDICAL   DEPABTMENT.   TJ.    S.    NAVY.        263 

(e)  After  approval  the  third  will  be  returned  to  the  officer  making  the  requi- 
sition ;  the  fourth  will  be  filed  at  the  bureau ;  the  first  and  second  will  be  for- 
warded to  the  supply  depot,  and  will  accompany  the  stores  when  shippe<l. 

(/)  The  medical  officer  of  the  supply  depot  filling  the  requisition  will  enter 
the  value  of  each  item  in  the  proper  column  before  forwarding  the  first  and 
s:econd  to  the  maker  of  the  requisition. 

(g)  Upon  receipt  of  stores  the  value  shall  be  entered  on  the  third,  and  the 
tirst  and  second,  properly  receipted,  shall  be  forwarded,  the  former  to  the  supply 
ilepot  and  the  latter  to  the  Bureau  of  Medicine  and  Surgery. 

(h)  This  form  must  not  be  altered  by  erasure  or  interlineation.  If  additional 
articles  are  required,  requisition  for  such  articles  shall  be  made  upon  Form  4 
or  Form  Ba. 

(i)  Stores  and  supplies  on  board  in  charge  of  other  officers,  if  needed  for 
the  sick,  may  be  obtained  upon  requisition  duly  approved  by  the  commanding 
officer  and  a  receipt  given.    I  4422. 

»931  (2).  Form  B— dental. 

id)  Dental  requisitions  will  conform  with  (a)  to  (c)  of  the  preceding 
paragraph. 

(6)  Requisitions  for  dental  supplies  will  be  regularly  numbered  In  the 
medical  department  series  of  the  ship  or  station. 

(c)  The  form  must  not  be  altered  by  erasure,  interlineation,  or  addition.  If 
articles  not  on  this  form  are  requiretl,  requisition  for  same  will  be  made  on 
appropriate  form.  Such  a  requisition  must  in  all  instances  be  accompanied  by^ 
11  n  explanatory  letter  as  to  the  necessity  for  the  articles.  ^^ 

(d)  Where  the  quantity  or  number  of  an  article  in  a  container  is  stipulated,, 
requisition  will  always  be  made  for  the  full  package,  e.  g.,  burs  In  packages  of 
six ;  carborundum  points  in  packages  of  four,  etc. 

(e)  After  approval  by  the  bureau  the  fourth  is  retained,  the  third  returned 
to  the  officer  making  the  requisition,  and  the  first  and  second  forwarded  to  a 
naval  medical  supply  depot.  Upon  shipment  of  the  stores  from  the  supply 
<lepot  the  first  and  second,  with  value  of  stores  entered,  are  forwarded  to  the 
officer  making  the  requisition.  The  prices  of  the  items  and  their  aggregate 
value  shall  be  entered  on  the  third. 

(/)  After  verification  of  the  shipment  the  first,  second,  and  third  shall  bo 
<Uily  receipted.  The  receipted  first  shall  be  forwarded  to  the  supply  depot 
filling  the  requisition,  the  receipted  second  forwarded  to  the  Bureau  of  Medi- 
cine and  Surgery,  and  the  receipted  third  retained  for  the  files  of  the  ship  oi- 
station. 

(g)  The  names  of  expendable  articles  are  printed  in  roman  type  and  non- 
expendable in  italics.  Nonexpendable  articles  that  have  become  unfit  for  fur- 
ther use  shall  be  surveyed  and  condemned  before  the  issue  of  others  to  replace 
them.  When  a  nonexpendable  article  is  requisitioned  for,  the  date  of  approved 
survey  shall  be  entered  as  a  footnote  on  the  requisition, 

:i932.  Form  Ba.  Special  requisition.  ii'i  o  •. 

(a)  Form  Ba  shall  be  prepared  in  quadruplicate.  It  embffeees a  supplementary 
list  of  articles  (on  charge,  but  not  included  in  the  supply  table)  in  store  at 
medical  supply  depots.  Such  articles,  upon  approved  requisitions,  will  be  fur- 
nished if  in  stock. 

(6)  In  the  preparation  of  Form  Ba  medical  officers  shall  be  guided  by  the  i!\- 
structions  relating  to  the  pi'eparation  of  requisition  Form  B. 

3933.  Form  4    Requisition  for  supplies. 

(o)  This  form  shall  be  used  in  making  requisition  \ipon  the  naval  medical 
supply  depots  for  articles  not  on  the  supply  table  and  for  articles  on  the  supply 
table  when  only  a  few  items  are  required.  For  articles  on  Form  B  and  those 
not  on  Form  B  separate  requisitions  will  be  made.  Requisitions  from  shor«« 
stations  in  the  United  States  for  articles  not  on  the  supply  table  will  be  made  on 
Form  1.     I  2119  (4).  i  •   i 

(ft)  This  requisition  shall  be  made  in  qiiadriiplicate,  numbered  and' 'ma rK^' 
as  noted  under  Form  B.  tDd-ncmfoo  sljl  oj 


2(>4        MANUAL  FOR   THE   MEDICAL  DEPABTMENT,   U.    S.    NAVY. 

(c)  The  quantities  of  medicines  required  shall  correspond  in  amount  to  the 
packages  mentioned  in  the  supply  table. 

(d)  After  approval  the  third  will  be  returned  to  the  ofticer  making  the  requi- 
sition ;  the  fourth  will  be  filed  at  the  bureau ;  the  first  and  second  will  be  for- 
warded to  the  naval  medical  supply  depot  filling  the  requisition  and  shall  accom- 
pany the  stores  when  shipped. 

(e)  The  medical  officer  of  the  supply  depot  filling  the  requisition  shall  enter 
the  value  of  each  item  in  the  proper  column  before  forwarding  the  first  and 
second  to  the  maker  of  the  requisition. 

(/)  Upon  receipt  of  stores,  the  value  shall  be  entered  on  the  third,  and  the 
first  and  second,  properly  receipted,  shall  be  forwarded,  the  former  to  the 
medical  supply  depot  furnishing  the  stores  and  the  latter  to  the  Bureau  of 
Medicine  and  Surgery. 

(g)  Articles  requisitioned  for  shall  be  arranged  alphabetically  and  by  classes, 
as  indicated  in  the  supply  table. 

(h)  Requisitions  for  articles  not  on  the  supply  table  will  be  submitted  when 
necessary.  They  must  be  made  in  quadruplicate  and  accompanied  with  an 
explanatory  letter  stating  the  necessity  for  each  item  required.    I  2119  (5). 

39S4.   I'^orms  C  and  Cn.  Surveys  on  medical  property.     See  ch.  17,  sec.  7. 

3935.  Form  D,  inventory  of  property,  and  Form  Da,  inventory  of  property 
(additional  articles)    (blank). 

(a)  The  attention  of  medical  officers  is  directed  to  articles  I  2118;  I  2124; 
I  2125 ;  and  I  3255,  Naval  Instructions,  relating  to  the  preparation  of  Forms  D 
and  Da,  "Inventory  of  proj^rty,"  and  "Inventory  of  property  (itemized  ar- 
ticles)." All  accurate  inventory  down  to  date  of  all  property  belonging  to  the 
Medical  Department  of  the  Navy  shall  be  kept  on  file  at  shore  stations  and 
on  ships. 

(b)  An  annual  inventory  of  the  nonexpendable  articles  on  hand  shnll  be  pre- 
paretl  and  forwarded  to  the  Bureau  of  Medicine  and  Surgery  on  the  1st  day  of 
July  of  each  year. 

((')  Use  typewriter  when  practicable,  enter  items  on  Form  Da  only;  number 
each  sheet  and  enter  name  of  station  or  ship  thereon ;  arrange  articles  alpha- 
betically and  by  classes  (a)  on  ships  and  shore  stations  other  than  hoispltals.  to 
conform  with  the  arrangement  of  the  supply  table,  and  (b)  at  hospitals,  in 
accordance  with  departments  indicated  in  the  hospital  bill  hook;  each  sheet 
to  be  lieaded  with  the  name  of  the  hospital  department  and  number  of  bill-book 
c<jUunn  concerned,  and  a  subhead,  if  necessary,  to  locate  definitely  the  property, 
e.  g.,  furniture,  etc.,  staff  quarters,  bill-book  column  17,  House  "A  " ;  furniture 
and  furnishings,  bill-book  column  34,  isolation  building,  etc. 

('I)  When  llie  iiiveniory  lins  l)een  coniiiieted,  arruTige  the  .sheets  in  numerical 
Older,  face  tlie  inventory  with  Form  D  properly  prepai"«d,  and  fasten' the  whole 
securely  before  forwarding. 

(e)  When  property  is  transferred  from  one  medical  officer  to  another,  the 
prepariition  of  an  itemized  inventory  Is  not  required,  but  the  receiving  officer 
should  satisfy  himself  that  the  articles  on  hand  correspond  with  the  inventory 
on  file  before  receipting  for  same.  The  statement  that  the  property  has  been 
received  shall  be  accomplished  in  quadruplicate — one  copy  to  be  retained  by 
each  medical  officer,  one  copy  filed  with  the  records  of  the  ship  or  station,  and 
one  copy  forwarded  to  the  Bureau  of  Medicine  and  Surgery. 

(/)  Medical  outfits  for  ships  in  commission  shall  be  furnishe^l  from  a  supply 
depot.  At  naval  stations  where  there  is  no  supply  depot  the  medical  niHcer  of 
the  navy  yard  shall  have  charge  of  all  medical  supplies  for  ships  fitting  out, 
for  ships  going  out  of  commission,  or  received  from  ships  arriving  at  the  yard. 
It  4623.  When  medical  supplies  are  transferred  from  one  ship  or  station  to 
another,  invoices  and  receipts  in  triplicate  must  be  jtrepared,  apin-oved  by  tlie 
senior  officer,  and  disposed  of  in  the  same  manner  as  though  at  u  navy  yard. 

((/)  When  a  medical  odicer  or  hospital  cori)sn)an  iti  chai'ge  of  pulilic  prop- 
erty Is  detJiched  before  the  arrival  of  a  relief  he  should  transfer  all  medical 
property  to  his  commanding  or  other  responsible  officer  and  tuke  a  receipt 
therefor. 


MANUAL   FOR   THE    MEDICAL   DEPARTMENT,    U.    S.    NAVY.        265 

(h)  When  a  ship  is  placed  out  of  c®mmission  the  senior  medical  officer  shall: 
(a)  Carefully  pack  all  medical  supplies,  including  books  and  blank  forms,  and 
unless  otherwise  directed  deliver  same  properly  marked  to  the  general  store- 
keeper of  the  navy  yard  for  shipment  to  the  nearest  naval  medical  supply 
depot.  They  shall  be  accompanied  by  an  accurate  inventory  in  triplicate, 
made  out  in  order  of  the  supply  table.  The  inventory  shall  be  signed  by  the 
medical  officer  and  approved  by  the  commanding  officer.  I  2124.  (b)  Se- 
curely pack  the  microscopical  outfits  and  accessories  and  deliver  same  prop- 
erly marked  to  the  general  storekeeper  of  the  navy  yard  for  shipment  by  pre- 
paid express  to  the  medical  officer  in  command  United  States  Naval  Medical 
School,  Washington,  D.  C,  and  notify  the  latter  officer  by  letter  of  the  ship- 
ment, (c)  Forward  the  Journal  of  the  Medical  Department  to  the  Bureau  of 
Medicine  and  Surgery. 

(i)  Medical  officers  will  not  be  released  from  responsibility  for  the  value  of 
any  nonexpendable  articles  unless  the  expenditure  shall  have  been  authorized 
by  the  bureau  or  a  board  of  survey.    I  3255  (3). 

ij)  The  property  return  from  ships  in  squadron  shall  be  forwarded  through 
the  commander  in  chief,  who  will  require  the  fleet  surgeon  to  report  to  the 
bureau  any  instances  of  unauthorized  expenditure  of  property. 

3930.  Form  F.  Quarterly  abstract  of  patients. 

(a)  The  "  Quarterly  abstract  of  patients  "  (Form  F)  shall  accord  with  and  be 
accompanied  by  Form  F  (rough)  and  the  statistical  report  (Form  K),  and  shall 
contain  the  names  of  officers  and  men  of  the  Navy  and  Marine  C<5rps  and  those 
of  the  native  and  insular  forces  on  the  active  list  only,  rate,  diagnosis,  key 
letter,  and  sick  days  of  every  case  admitted  to  the  sick  list.  Retired  officers 
and  men,  beneficiaries,  officers  and  men  of  the  Naval  Auxiliary  Sei-vice,  and 
members  of  the  Nurse  Corps,  shall  be  reported  on  this  form  but  listed  sep- 
arately and  headed  "  Supernumeraries,"  and  not  considered  when  computing 
the  total  number  of  sick  days. 

The  ribbon  copy  of  Form  F  when  typewritten  shall  be  forwarded  to  the 
bureau. 

(6)  This  form  shall  be  forwarded  to  the  Bureau  of  Medicine  and  Surgery 
from  all  hospitals,  hospital  ships,  ships,  and  shore  stations  for  a  whole  or  a  frac- 
tion of  the  quarters  ending  March  31.  .June  30,  September  30,  and  December  31 
of  eaeh  year  and  when  a  ship,  hospital,  or  station  is  placed  out  of  commission. 
The  data  required  for  its  preparation  shall  be  taken  from  rough  Form  F,  kept 
for  the  purpose,  upon  which  the  necessary  entries  shall  have  been  made  from 
health  records.  If  there  have  been  no  sick  during  the  period  covered  by  the 
report  it  shall  be  so  stated  across  the  face. 

(c)  The  names  shall  be  arranged  in  strictly  alphabetical  order,  using-  addi- 
tional sheets  as  may  be  necessary  to  contain  the  entries,  but  the  pages  shall  not 
be  extended  by  appended  sheets  and  the  record  should  be  continuous  without 
unnecessary  spacing. 

(d)  In  the  preparation  of  Form  F  (rough)  the  following  instructions  shall  be 
carefully  followed : 

It  shall  be  prepared  in  duplicate  for  every  case  taken  up  for  record.  The 
original  forwarded  to  the  Bureau  of  Medicine  and  Surgery,  Navy  Department 
and  the  duplicate  retained  for  office  files.  The  data  for  its  preparation  shall 
be  obtained  from  the  health  record.  Only  completed  cards  for  cases  disposed 
of  during  a  quarter  shall  be  forwarded,  except  for  the  quarter  ending  December 
31,  when  all  cases  shall  be  reported  and  new  cards  shall  be  prepared  for  cases 
continued  to  next  year.  Completed  cards  shall  be  forwarded,  accompanied  by 
Forms  F  and  K.  for  the  quarters  ending  March  31,  June  30,  Septemper  30,  and 
December  31,  of  each  year,  and  when  a  ship  is  placed  out  of  commission,  or  a 
station  or  hospital  closed. 

Supernumeraries :  Cards  for  this  class  of  cases  shall  be  prepared  but  shall 
not  be  forwarded  to  the  bureau  except  upon  request. 

Instructions  for  numbered  lines: 

1.  Surname  and  Christian  names  in  full ;  grade  or  rate,  see  paragraph  2241. 

2.  For  enlisted  men  only.     Leave  blank  for  officers. 


266        MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.   S.   NAVY. 

3.  Uuder  place  give  State  or  country  If  foreign  born. 

4.  When  patient  is  received  from  some  other  place.    Otherwise  leave  blank. 

5.  Only  terms  found  in  paragraphs  2359-2361.  Key  letters  shall  be  assignorl 
for  all  wounds,  etc.,  and  poisons. 

6.  Use  letters  called  for  In  the  health  record,  and  indicate  remaining  from 

last  year  by  a  .     Origin;  indicate  duty  by  D,  not  duty  by  N  D,  and 

unknown  by? 

7.  Use  letters  called  for  in  the  health  record  and  indicate  continued  to  next 
year  by  a  .  Record  number  of  sick  days  this  calendar  year.  In  com- 
puting sick  days  the  day  of  discharge  hut  not  the  day  of  admission  shall  be 
considered  a  sick  day.  Cases  taken  up  and  disposed  of  the  same  calendar  day 
shall  not  be  considered  or  counted  a  sick  day. 

8.  When  patient  is  transferred  to  some  other  place.  Otherwise  leave  blank. 
See  health  record  under  "Transferred." 

10.  Name  of  ship,  station,  or  hospital  preparing  and  forwarding  card. 

(e)  Medical  officers  on  duty  at  places  from  which  the  regular  quarterly  re- 
turns, Forms  F  and  K,  are  not  required,  such  as  recruiting  duty  or  detached 
duty  of  any  nature,  shall,  when  cases  of  illness  are  brought  to  their  attention, 
prepare  and  forward  rough  Form  F  cards.  A  supply  of  cards  for  this  pur- 
pose may  be  obtained  upon  application  to  the  bureau. 

(/)  In  the  case  of  treatment  of  persons  on  leave  from  their  regular  ship  or 
station  the  medical  officer  at  the  place  to  which  the  person  is  attached  as  well 
as  the  bureau  shall  be  informed. 

(g)  Notation,  Naval  Reserve  (all  classes)  and  supernumeraries. 

Officers  and  men  of  the  Naval  Reserve  (all  classes)  when  on  active  duty 
shall  be  treated  in  all  respects,  for  record  purposes,  as  officers  and  men  of  the 
active  force  of  the  Navy  and  shall  be  accounted  for  on  all  repoits  and  returns 
as  such.  This  also  applies  to  National  Naval  Volunteers  (Naval  Militia)  when 
drafted  into  the  regular  service. 

In  accounting  for  supernumeraries  on  Form  P,  under  the  title  "  Grade  or 
rate,"  indicate,  as  far  as  possible,  a  retired  officer  or  man  by  giving  grade  or 
rate  followed  by  the  letters  "  RET  " ;  officers  and  men  of  the  Naval  Auxiliary 
Service  by  grade  or  rate  followed  by  "  NAS  " ;  ex  service  people  by  the  letters 
"  EX  "  followed  by  the  grade  or  rate  previously  held ;  members  of  Nurse  Corps 
(female)  by  "NURSE";  members  of  other  naval  or  military  organizations  by 
grade  or  rate  followed  by  the  nationality  or  other  definite  indication;  and 
civilians  by  "CIV." 

The  term  "  SUPER  "  for  supernumeraries  in  general,  ha.s  not  been  very  satis- 
factory to  the  bureau  for  reference  purposes  and  by  close  adherence  to  the 
above  or  definite  designations  the  bureau  will  be  in  possession  of  better  informa- 
tion in  dealing  with  certain  cases. 

8937.  Form  G.  Hospital  ticket. 

(a)  The  instructions  contained  in  articles  K  35S2  and  1  3220  require  thai 
patients  transferred  to  a  hospital  shall  be  accompanied  upon  admission  by 
hospital  tickets,  ai)proved  by  the  commanding  officer. 

(6)  In  cases  of  emergency,  patients  may  be  admitted  without  a  hospital 
ticket,  but  the  necessity  for  such  action  .shall  be  reported  by  the  senior  nedical 
officer  of  the  hospital  to  the  commandant  of  the  station,  who  shall  cause  tJie 
ho.spital  ticket  to  be  furnished. 

(c)  When  the  ho.spital  tlckci  lias  been  examined  and  the  clothing  c'leoke'l 
on  the  list  of  clothing  appt-aring  on  the  reverse  side  and  found  correct,  it  shaii 
be  filed  and  retained  until  the  completion  of  the  case.  Upon  final  disposition 
the  effects  of  the  patient  shall  be  receipted  for  by  him  and  the  receipted  tickei 
pluct'd  in  the  files. 

3i>3S.   Form  H.  Tleallli  reconls  .    (Sei?  ch.  13.) 
8989.  Form  I.  Weekly  report  of  sick. 

(a)  Article  I  3238.  Navid  Instructions,  specifies  when  and  lu  what  nmntie 
the  weekly  report  of  sick  shall  be  prepared. 


MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVV.        267 

.  (6)  Form  I  shall  be  prepared  in  triplicate  on  Monday  of  each  week  for  tlu' 
week  ending  the  preceding  Saturday,  at  all  naval  hospitals  and  hospital  ships. 
One  copy  shall  be  sent  to  the  Bureau  of  Medicine  and  Surgery,  one  to  the  '.  om- 
raandant  of  the  station  or  the  commander  in  chief  (hospital  ships),  and  one 
retained  for  the  files  of  the  hospital,  as  a  basis  of  the  report  for  the  following 
week.    The  ribbon  copy  of  this  report  shall  be  forwarded  to  the  bureau. 

(c)  The  report  shall  l)e  signed  by  the  medical  officer  in  command  of  tne 
hospital,  and  shall  show  the  number  of  patients: 

(aa)  Remaining  at  last  report. 

(bb)  Admitted  during  the  week. 

(cc)  Totals. 

{dd)  Discharged  during  the  week. 

(ee)  Remaining. 

(j^')  Beds  for  officers— occupied ;  vacant;  total. 

(gg)  Beds  for  enlisted  men — occupied;  vacant ;  total. 

(d)  The  report  shall  also  contain  the  following  inforniation  In  the  appro- 
priate columns:  „    ^     -rn.   .™,      ;  '1o 

Column  1.  A..  D.,  C,  D.  D.,  H.  I.,  H.  T.,  I.  S.,  L.,  R.,  T.  ! 

■  Column  2.  Name  (surname  and  initials  only)  arranged  chronologically  by 
date  of  admission,  officers  first  and  underscored. 

Column  3.  Rank,  grade,  or  rate. 

Column  4.  Disease  (diagnosis). 

Column  5.  Where  from  (ship  or  station).  i-   .„.',,  >      ... 

Column  6.  When  admitted;  the  date  shall  be  expr^fefea-;m-fi§«i^e^^  i-  e.,  for 
Julv  15  make  entry  7-15.  ■     ;, '   : '  .'  .  ;  '„  ' .' J/, ;,  ,,    .  .  . 

Column  7.  When  discharged;  the  date  shftn^-^'fexpi-essefl^^Q'flgHft^,'  i'.  ft/foi 

July  15  make  entry  7-15.  ■•:r ^V  ['rll'':!''  ■'X':^;!:  vt    -.'/r' 

Column  8.  Days  in  hospitaL  '     '   '    ''"^-J'    l^ll     ,Ly  \^- 

Column  9.  Condition;  convalescent    (C)  ;  :fav6rablen(FV)'t  "S^^i^Wte  j(«)J^^^^ 

^Sumn  10.  Probable  date  of  fitness  for  duty,  i*.  ^  foi^  July  K  make  entry  7-15^ 

(e)  The  surname  of  ofticer  patients  will  be  underlined  with  r&d  ink,  and 
officers  entered  first  on  the  report.  '  «'j'.    '   ''  '  •; 

3940.  Form  K.     Statistical  report.     (See  ch.  13.  ser».  S:);    "   '; 

3941.  Form  K:.     Report  of  casualties.     (I  5222  (5)r.)      ''    '"I, 

3942.  Form  L.  Request  lor  medical  survey.     (See  "  Surveys,"  ch.^l<.) 

3943.  Form  M.  Report  of  medical  survey.     (See  "Surveys,"  ch.  17.) 

3944.  Form  N.  Report  (certificate)  of  death.     (See  ch.  13,  sec.  14.) 

3945.  Form  O.  Request  for  blank  forms.  -  ^vs 
Form  O  contains  a  list  of  forms  employed  in  thJeMeitJicai' Departrtienk-^  the 

Navy  Whenever  blank  forms  ai-e  required,  medical  officers  sTiall  submit  to 
the  naval  medical  supply  depot,  Brooklyn,  N.  Y.,  such  request  on  F'orm  O, 
designating  the  particular  forms  required  by  an  X  sign,  and  stating  the  num- 
ber required. 

3946.  Form  P.  Report  of  surgical  operations. 

(a)  One  copy  shall  be  submitted  to  the  Bureau  of  Medicine  and  Surgery 
annually,  for  the  year  ending  December  31,  and  when  a  ship,  station,  yard,  or 
hospital  is  placed  out  of  commission.  ,       "       1 .  ,/■    ^  .!.^,> 

(b)  All  operations  shall  be  reported  except  those'Of  a' v^tfy'tfrNial-flatnW. 
The  form  shall  be  kept  posted  to  date  that  data  may  be  obtained  by  the  bureAti' 
at  any  time.  The  data  required  in  each  column  will  be  stated  in  brief,  and 
each  case  will  be  separated  from  the  preceding  one  by  a  line.  ' 

(c)  When  an  operation  Is  performed  for  a  single  condition  and  its  iniMWMhirte 
complication,  one  operation  only  shall  be  recorded,  but  when  several  operations 
have  been  performed  for  distinct  conditions,  each  operation  must  be  recorded 
separately  e.  g.,  inguinal  hernia,  varicocele,  and  varicose  veins  of  leg  all 
performed 'while  under  one  general  anesthetic  should  appear  on  Form  P  as 
three  distinct  operations,  giving  the  Information  required  in  e.i<-h  column. 


268        MANUAL  FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

id)  Column  1.  Give  initials  and  grade  or  rate  of  patient.  See  paragraph 
2241  (6),  also  date  of  operation,  as  follows: 

FUR. 
Y-1. 
7-10. 

Column  2.  Use  the  terms  of  the  nomenclature  and  state  location  when  not 
covere<l  by  title. 

Column  3.  State  the  character  or  the  name  of  the  operation. 

Column  4.  Use  the  following  terras  in  describing  the  result;  C.  cured;  DD, 
died ;  I.  improved ;  T,  transferred ;  U,  unimproved ;  and  use  no  other  terms  in 
this  column. 

Colunm  5.  Give  the  name  of  the  anesthetic  employed  and  the  method  used 
if  of  her  than  ordinary. 

Column  6.  Under  "  Remarks "  note  only  unusual  complications,  and  in  the 
case  of  death  give  direct  cause  regardless  of  the  operation. 

3017.  Form  Q.  Clinical  chart. 

(a)  Form  Q  shall  be  kept  in  such  cases  as  in  the  judgment  of  the  medical 
officor  may  require  it.  It  shall  contain  a  record  of  the  temperature,  pulse,  res- 
piration, and  a  microscopical  examination  and  a  cliemical  examination  of  the 
urine,  etc. 

3948.  Form  S.  Ration  notice  (admission).  See  I  3234;  I  4552  (Civil  em- 
plovees:  See  par.  1276). 

The  day  from  which  subsisted  as  shown  by  the  ration  notice  of  admission 
shall  be  the  day  following  the  actual  entry  of  the  patient  into  the  hospital. 

3949.  Form  T.  Ration  notice  (discharge). 

(o)  When  a  patient  is  discharged  from  a  hospital  a  ration  notice  shall  be  for- 
warded, as  directed  upon  the  entry  of  a  patient. 

(h)  The  last  day  subsisted  in  the  hospital,  as  shown  by  the  ration  notice  of 
discharge,  shall  be  the  day  upon  which  the  patient  leaves  the  hospital. 

3950.  Form  V.  Quarterly  return  of  medical  stores. 

(«)  Form  V  is  only  used  in  the  preparation  of  returns  from  naval  medical 
supply  depots. 

(6)  Unless  otherwise  required  it  shall  be  prepared  and  forwarded  at  tne  end 
of  each  quarter  to  the  Bureau  of  Medicine  and  Surgery  ami  shall  be  signed  by 
the  medical  <»llicer  in  command  of  the  naval  medical  supply  depot  responsible  for 
the  stores. 

(c)  The  form  shall  show  total  receipts  and  total  expenditures  of  all  medical 
stores,  the  articles  recef\'ed  and  expendetl  being  ela.ssitietl  in  the  onler  in  which 
they  appear  on  the  Supply  Table  of  the  Meilical  Department  of  the  Navy. 

3951.  Form  X.  Abstract  of  enlistments,  and  Form  X  (rough), 
(a)  No  Form  X  is  required  in  the  case  of  an  officer. 

(5)  Form  X  shall  be  prepared  from  the  "  Form  X  (rough)"  kept  for  the  pur- 
pose, and  will  be  forwarded  from  receiving  ships.  Navy  anil  Marine  Corps  re- 
cruiting stations,  and  marine  recruit  deiK»ts  for  the  quarters  ending  March  31. 
.Tune  30,  September  30,  and  December  31,  from  otlier  ships,  stations,  or  yards 
for  the  year  ending  December  81,  or  when  a  ship  is  placed  out  of  conmiission 
or  a  re«-ruiting  or  other  .stati<m  closed. 

(c)  A  copy  shall  be  retained  for  ship  or  .station  files.  If  there  have  been  no 
appli<-ants,  the  report  should  be  forwarded,  and  this  fact  so  .state<l  in  the  spaces 
opiM)site  "  Nhvv  "  and  "  Marine  Corps." 

id)  Central  recruiting  stafionH  shall  include  In  their  report  the  substations 
and  traveling  parties  comljig  under  their  j\irls(liction. 

(e)  Medi<;al  Ollicers  of  ships,  naval  stations,  or  yards  making  examinations 
for  .ships  or  stations  to  which  no  medical  ollicer  is  assigne<l  shall  include  thes*- 
(•a.scH  in  flielr  report.s. 

(/)  Form  X  (rough)  shall  he  prei»arc<l  for  each  applicant  examined,  whether 
a<<('ptcd  or  rejected,  oiiirinal  or  rcenlistnicnt,  and  will  be  kei)t  fo'-  the  i>nr]H>se 
of  j)rcparing  Form  X.  li  shall  be  retained  for  ship  or  station  files  and  shall  be 
filed  alphabetically,  by  calendar  years,  a<'c<ft-ding  to  the  .ippllc  nnt's  surname,  in 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.    B.    NAVY.        269 

order  that  informatioa  may  be  furnished  the  bureau  upon  request.    The  exam 
iner  should  be  careful  to  strike  out  the  terms  not  to  be  used. 

(g)  Marine  recruit  depots  shall  distinguish  between  "Accepted  applicants" 
transferred  from  recruiting  stations  to  the  depot  and  those  applying  originally 
at  the  depot  by  making  the  proper  entry  in  the  space  provided  on  this  form. 

(h)  Previous  Army  service  shall  not  be  considered  a  reenlistment.  A  candi- 
date for  enlistment  in  general  service  with  previous  service  in  the  Insular  force 
shall  be  returned  as  an  enlistment,  not  a  reenlistment. 

Previous  Navy  or  Marine  Corps  service  shall  be  considered  a  reenlistment  in 
the  Navy,  and  previous  Navy  or  Marine  Corps  service  shall  be  considered  a 
reenlistment  in  the  Marine  Corps,  so  far  as  it  applies  for  use  in  the  preparation 
of  this  form. 

3953.  Changes  in  Hospital  Corps  (N.  M.  S.  125682)  ;  Medical  officer  pre- 
pares this  form  (mailing  card)  for  signature  of  commanding  officer,  to  be  for- 
warded direct  to  Surgeon  General,  immediately  upon  enlistment,  transfer, 
death,  desertion,  change  of  rating  (except  when  such  change  occurs  within  the 
Hospital  Corps  itself,  such  as  from  hospital  apprentice,  second  class,  to  hospital 
apprentice,  first  class),  or  discharge  for  any  cause  (except  expiration  of  enlist- 
ment) of  each  Hospital  Corpsman  attached  to  his  ship  or  station.  (Navigation 
Circular  Letter,  Mar.  8,  1913.) 

3954.  Form  N.  M,  S.  No.  42022  is  prepared  by  medical  officer  under  whom 
candidate  is  serving  and  forwarded  to  examining  board  and  Bureau  of  Medicine 
and  Surgery  whenever  members  of  Hospital  Corps  are  examined  for  promotion 
to  ratings  of  pharmacist's  mate  first  class  or  chief  pharmacist's  mate. 

Section  4. — Miscixi^neous  Forms. 

3961.  Special  diet  list  (hospitals). 

(a)  In  filling  out  the  special  diet  list  medical  officers  shall  be  governed  by  the 
instructions  contained  in  articles  I  3232,  I  3233,  Naval  Instructions,  relating  to 
diet  tables  and  special  diet  lists. 

(6)  The  special  diet  list  shall  be  prepared  every  morning  by  the  medical 
officer  in  charge  of  the  ward.  When  there  are  two  or  more  medical  officers  in 
charge  of  patients  they  shall  use  the  same  blank,  in  each  case  filling  in  the 
blank  opposite  the  names  of  the  patients  under  their  charge.  They  will  en- 
deavor, as  far  as  possible,  to  secure  uniformity  in  the  orders  for  the  day  so  as 
to  avoid  imnecessary  cooking.  The  special  diet  list  shall  always  be  filled  by  the 
medical  officer  and  never  by  the  nurses.  It  will  include  the  dinner  and  supper 
of  the  day  when  made  out  and  the  breakfast  of  the  following  day.  As  occasion 
demands,  articles  in  addition  to  those  contained  on  the  list  may  be  employed. 

3962.  Pay  roll.     (Form  No.  8^,  Bureau  Supplies  and  Accounts.) 

In  the  preparation  of  the  pay  roll  for  civil  employees,  medical  officers  shall  be 
governed  by  the  following  instructions: 

(a)  The  pay  roll  is  used  at  all  naval  hospitals  and  naval  stations  in  the  pay- 
ment of  civil  employees  under  the  jurisdiction  of  the  Bureau  of  Medicine  and 
Surgery, 

(b)  Such  numbers  of  copies  shall  be  made,  and  at  such  times,  as  may  be  re- 
quired  for  payments,  in  addition  to  which  one  copy  shall  be  forwarded  to  the 
bureau  and  one  copy  retained  at  the  hospital  or  station. 

(c)  No  vacant  spaces  should  be  left  between  names  on  the  pay  roll,  and  the 
unused  spaces  below  the  last  entry  should  be  ruled  diagonally  across  the  page, 
the  roll  footed  up,  and  the  total  placed  in  the  space  provided  at  the  bottom  of 
the  rolL 

id)  This  roll  will  not  be  signed,  receipts  being  taken  only  when  payment  is 
made  by  the  pay  officer  in  person,  or  by  his  deputy,  and  in  cash — that  is,  cur- 
rency— and  the  delivery  of  such  receipts  is  simultaneous  with  the  payment. 

{'^)  When  payment  is'made  by  check  no  receipt  will  be  required 'or  taken. 
but  the  check  number,  date,  and  amount,  and  the  depository  on  whom  di'awu, 
will  be  shown  in  the  column  "  Remarks." 


270        MANUAL   FOB   I'HE    MEDIOAL   DEPABTMKNT,   U.    S.    NAVY. 

(/)  Clerks  will  give  individual  receipts  for  payments  lu  cash — that  Is,  cur- 
rency— on  the  same  form  as  provided  for  mechanics  and  laborers,  except  that 
their  signatures  need  not  be  attested. 

{g)  When  services  are  rendered  in  the  District  of  Columbia,  add  to  the 
certificates  the  following:  "And  that  the  full  period  of  service  covered  by  this 
roll  expired  prior  to  the  actual  signing  of  the  receipts." 

(h)  The  employment  of  laborers,  skilled  and  unskilled,  at  naval  hospitals 
is  not  subject  to  "the  provisions  of  the  civil-service  rules  or  navy-yard  regula- 
tions, in  view  of  the  provisions  of  Executive  order  of  June  13,  1905.  (Navy 
Yard  Order  No.  541;  revised  June  23,  1905.) 

3963.  Efficiency  report  (U.  S.  Naval  Hospital  Coips)   (Bur.  M.  and  S.). 
This  report  shall  be  forwarded  through  official  channels  to  the  Bureau  of 

Navigation,  for  transmission  to  the  Bureau  of  Medicine  and   Surgery,  Navy 
Department,  upon  the  transfer  of  any  member  of  the  Hospital  Corps. 

3964.  Subsistence  report.  Hospital  Corps  (No.  8805).  To  he  submitted  quar- 
terly to  the  bureau,  In  triplicate,  each  of  the  three  copies  to  bear  the  actual 
signature  of  the  commanding  officer. 

8965.  Ration  memoranda  for  .commissary  ledger.     (N.  M.  S.  No.  124716.)     li 

3966.  Reroipt  and  expenditure  voucher  for  commissary  ledger.  (N.  M.  «. 
No.   12471G.) 

3967.  MoTuing  report  of  patients.  This  report  is  submitted  daily  from  each 
ward  bv  the  ward  officer.  It  should  contain  the  following  information:  The 
number*  of  patients  remaining  from  last  report,  the  number  admitted,  the 
number  received  from  other  wards,  discharged,  died,  transferred  to  other 
wards,  on  leave,  absent  over  leave,  and  remaining  in  the  ward,  as  well  as  the 
number  of  empty  beds  and  tl\e  names,  rates,  and  disea.ses  of  patients  recom- 
mended for  discharge  to  duty  or  for  medical  survey. 

3968.  Standing  order  sheet.  This  order  sheet  is  designed  to  furnish  a  recor»l 
of  all  medicines  prescribed  and  the  times  of  administration,  whether  before 
meals  (a.  c),  after  meals  (p.  c),  every  four  hours  (q.  4  h.).  In  the  morning 
(a.  m.),  in  the  evening  (p.  m.),  or  as  needed  (p.  r.  n.). 

8969.  Clinical  notes.  This  sheet  is  provided  for  rocunliug  data  re?:ardiMi, 
each  patient  or  for  bedside  notes,  such  as  the  character  of  examinations  made, 
jnedlcines  inescribed,  nourishment  taken,  and  any  pertinent  remarks  regard- 
ing the  progress  of  the  case  that  may  seem  desirable  to  record. 

3970.  Property  accountability  card.  This  card  or  niemonindum  slip  Is  fur- 
nished for  convenience  in  stating  the  property  required  for  use  In  a  ward, 
the  articles  Issued,  and  those  requiring  survey.  It  is  to  be  signed  by  the 
executive  surgeon  and  by  the  property  chief  pharmacist's  mate. 

8971.  Diet  sheet.  This  form  is  prepare<l  for  the  convenience  of  the  coni- 
roissarj'  steward  (pharmacLst)  to  enable  him  to  provide  appropriate  diets, 
both  as  to  quality  and  quantity,  for  the  hospital  personnel.  This  sheet  should 
fontain  a  statement  of  the  total  number  of  patients,  number  of  regular  diets 
to  be  served  in  moss  room,  in  wards,  or  in  rooms,  and  the  total  number  of 
regular,  light  soft,  and  special  diets  required  for  the  day.  In  addition,  each 
sheet  will  have  entered  the  names  of  patients  for  whom  regiilar,  light,  soft,  or 
special  diet  is  ordered, 

3972.  Misconduct  report  (admi.ssiou  and  di.s<?harge>.  This  is  forwarded 
from  liospitals  and  hospital  ships  only  In  case  of  officers  and  uwn  whose  absence 
from  dnty  is  on  ac<;<>unt  of  disease  resulting  from  their  own  intemperate  use 
of  drugs  or  alcoholic  liquors  or  other  misconduct.  It  is  forwarde<.  to  the  com- 
manding officer  carrying  the  patlent'g^^  ax^ounts. 

SicrxJO.N  n.— Bureau  of  Navigation  Fobmb  Uskd  in  Hospitau 

3981.  Report  of  the  fitness  of  officers.     (See  ch.  26,  sec.  4.) 

3982.  Blank  request  for  leave  of  absence.     (N.  Nav.  21)6a.) 

3984.  Transfer  and  discharge  slip.     (N.  Nav.  Slip  No.  0.) 

3985.  T.ist  of  slips,  shipping  nrtlflcs,  and  enlistment  nx-ords  forwarded,  etc. 
(N.  Nav.  '.>0.) 


MANUAL   rOK    THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY.        271 

Section  6. — Bubeau  of  Supplies  and  Accounts  Fobms  Used  in  Hospital. 

3991.  Request  for  books  aud  blanks.     (S.  and  A.  Form  No.  173.) 

3992.  Pay  roll.     (Form  No.  84.)     (See  sec.  4.) 

3993.  Stub  requisition,     (S.  and  A.  Form  129A.) 

3994.  Request  for  transfer  of  labor.     (S.  and  A.  Form  No.  66.) 

3996.  Application  for  leave  (civil  employees).  (S.  and  A.  Form  No.  206c 
(revised).) 

3996.  Schedule  of  bills  of  lading.     (S.  and  A.  Form  No.  68.) 

3997.  Bill  of  lading.     (S.  and  A.  Form  No.  86.) 

3998.  Memorandum  bill  of  lading.     (S.  and  A.  Form  No.  86b.) 

3999.  Shipping  order.     (S.  and  A.  Form  No.  86d.) 

Skction  7. — Special  Oebtiticates  or  Forms   Sometimes   REtiUiKEo   in   Naval 

Hospitals. 

4001.  Medical  certificate  for  St.  Eliznbeths  Hospital.  (Department  of  In- 
terior form.)     (See  ch.  18,  sec.  2.) 

400'i.  Certificates  of  death  for  civil  authorities,  and  m  some  cities  the  fol- 
loAN'ing  are  required :  .     ,.,     ^.  ^  .  , 

(«)  Reports  of  cases  of  pulmonary  and  other  communicable  torms  of  tuber- 
culosis, and  the  recovery,  removal,  or  death  of  same. 

( b )  Report  of  contagious  disease. 

(c)  Report  of  recovei'y  of  contagious  disease* 


CHAPTER  25. 


MEDICAL  DEPARTMENT  REPORTS  AND  RETURNS. 

Section  1. — ^Naval  Instructions  Relating  to  Reports  and  Returns  in 

General. 

4101.  To  be  listed  in  naval  instructions.    I  5201  (1). 
4-102.  Periodical  returns,  how  authorized.    I  5201  (2). 

4103.  Reports  and  returns  to  be  reduced  to  the  requiremeuts  of  the  service. 
I  35;  I  5201  (3). 

4104.  Recommendations,  suggestions,  and  reports  on  special  subjects  not  to 
be  held  for  annual  report,  but  made  as  the  subjects  present  themselves.   I  5202  ( 1 ) . 

4105.  Annual  reports.    I  5202  (2). 

4106.  Duplicates  of  reports  to  be  so  noted.    I  5204. 

4107.  Officers  required  to  submit  reports  to  keep  themselves  supplied  v^^ith 
necessary  blanks.     I  5205. 

98601°— 17 18  273 


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S  o  =>  „; 

ii 


CHAPTER  26. 


THE  GENEVA  CONVENTIONS. 

THE   HAGUE  PEACE   CONFERENCES   AND    CONVENTIONS    AND   THE    AMERICAN 

NATIONAL  RED  CROSS. 

Section  1. — The  Geneva  Convention  of  1864. 

4201.  The  convention  between  the  United  States,  Baden,  Switzerland,  Bel- 
gium, Denmark,  Spain,  France,  Hesse,  Italy,  Netherlands,  Portugal,  Prussia, 
Wurttemberg,  Sweden,  Greece,  Great  Britain,  Mecklenburg-Schwerin,  Turkey, 
Bavaria,  Austria,  Russia,  Persia,  Roumania,  Salvador,  Montenegro,  Servia, 
Bolivia,  Chile,  Argentine  Republic,  Peru,  and  Japan;  with  additional  articles: 
For  the  amelioration  of  the  wounded  in  armies  in  the  field ;  concluded  August 
22,  1864 ;  acceded  to  by  the  President  March  1,  1882 ;  accession  concurred  in  by 
the  Senate  March  16,  1882;  proclaimed  as  to  the  original  convention,  but  with 
reserve  as  to  the  additional  articles,  July  26,  1882,  commonly  known  as  the 
Geneva  Convention,  is  as  follows: 

OEIGINAL  CONVENTION. 

4202.  Abticle  1.  Ambulances  and  military  hospitals  shall  be  acknowledged 
to  be  neuter,  and  as  such  shall  be  protected  and  respected  by  belligerents  so 
long  as  any  sick  or  wounded  may  be  therein. 

Such  neutrality  shall  cease  if  the  ambulances  or  hospitals  should  be  held  by  a 
military  force. 

4203.  Art.  2.  Persons  employed  in  hospitals  and  ambulances,  comprising  the 
staff  for  superintendence,  medical  service,  administration,  transport  of  wounded, 
as  well  as  chaplains,  shall  participate  in  the  benefit  of  neutrality  while  so  em- 
ployed and  so  long  as  there  remain  any  wounded  to  bring  in  or  to  succor. 

4204.  Akt.  3.  The  persons  designated  in  the  preceding  article  may,  even  after 
occupation  by  the  enemy,  continue  to  fulfill  their  duties  in  the  hospitals  or  am- 
bulance which  they  serve,  or  may  withdraw  in  order  to  rejoin  the  corps  to  which 
they  belong. 

Under  such  circumstances,  when  these  persons  shall  cease  from  their  func- 
tions, they  shall  be  delivered  by  the  occupying  army  to  the  outposts  of  the 
enemy. 

4205.  Aet.  4.  As  the  equipment  of  military  hospitals  remains  subject  to  the 
laws  of  war,  persons  attached  to  such  hospitals  can  not,  in  withdrawing,  carry 
away  any  articles  but  such  as  are  their  private  property. 

Under  the  same  circumstances  an  ambulance  shall,  on  the  contrary,  retain  Its 
equipment. 

4206.  Akt.  5.  Inhabitants  of  the  country  vi'ho  may  bring  help  to  the  wounded 
shall  be  respected  and  shall  remain  free.  The  generals  of  the  belligerent  pow- 
ers shall  make  it  their  care  to  inform  the  inhabitants  of  the  appeal  addressed  to 
their  humanity  and  of  the  neutrality  which  will  be  the  consequence  of  it. 

Any  wounded  man  entertained  and  taken  care  of  in  a  house  shall  be  con- 
sidered as  a  protection  thereto.  Any  inhabitant  who  shall  have  entertained 
wounded  men  In  his  house  shall  be  exempted  from  the  quartering  of  troops  as 
well  as  from  a  part  of  the  contributions  of  war  which  may  be  imposed. 

285 


286         MANUAL   FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY. 

4207.  Art.  6.  Wounded  or  sick  soldiers  shall  be  entertained  and  taken  eiirL» 
of.  to  whatever  nation  they  may  belong. 

Commanders  in  chief  shall  have  the  power  to  deliver  immediately  to  the  out- 
posts of  the  enemy  soldiers  who  have  been  wounded  in  an  engagement,  when 
circumstances  permit  this  to  be  done,  and  with  the  consent  of  both  parties. 

Those  who  are  recognized,  after  their  wounds  are  healed,  as  incapable  of  serv- 
ing shall  be  sent  back  to  their  country. 

The  others  may  also  be  sent  back  on  condition  of  not  again  bearing  arms  dur- 
ing the  continuance  of  the  war. 

Evacuations,  together  with  the  persons  under  whose  directions  they  take 
place,  shall  be  protected  by  an  absolute  neutrality. 

4208.  Art  7.  A  distinctive  and  uniform  flag  shall  be  adopted  for  hospitals, 
•ambulances,  and  evacuations.  It  must,  on  every  occasion,  be  accompaWit'd  by 
the  national  flag.  An  arm  badge  (brassard)  shall  also  be  allowed  for  indi- 
viduals neutralized,  but  the  delivery  thereof  shall  be  left  to  military  anthorify. 

The  flag  and  the  arm  badge  shall  bear  a  red  cross  on  a  white  groiind. 

4209.  Art.  8.  The  details  of  execution  of  the  present  convention  shall  bo 
regulated  by  the  commanders  in  chief  of  belligerent  armies,  according  to  the 
instructions  of  their  respective  governments  and  in  conformity  with  the  general 
principles  laid  down  In  this  convention. 

Section  2. — The  Geneva  Convention  of  1868. 

'  additional  AKTICLES.*  .  l. 

il.Tr;7    ;;;(!     '.i>,:VT-t  ■:■<<<■■    liUii-jr  •    ■•■■     ■■"        •        "'J 

'  ''iSll?  Aii^ci^'l.  Tttfe  persons  designated  in  article  2  of  the  convention  shail. 
after  the  occupation  by  the  enemy,  continue  to  fulfill  their  duties,  aceordinj:  to 
their  wants,  to  the  sick  and  wounded  in  the  ambulance  or  the  hospital  which 
they  serve.  When  they  request  to  withdraw,  the  commander  of  the  occupying 
troops  shall  fix  the  time  of  departure,  which  he  shall  only  be  allowed  to  delay 
for' a  short  time  in  case  of  military  necessity. 

4212.  Art.  2.  Arrangements  will  have  to  be  made  by  the  belligerent  po\v#r.s 
to  insure  to  the  neutralized  person,  fallen  into  the  hands  of  the  army  of  tlic; 
enemv,  the  entire  enjoyment  of  his  salary.  ; 

4213.  Art.  3.  Under  the  conditions  provided  for  in  articles  3  and  4  of  the 
convention,  the  name  "ambulance"'  applies  to  field  hospitals  and  other  tem- 
porary establishments,  which  follow  the  troops  on  the  field  of  battle  to  receive 
the  sick  and  wounded.  ,  ,,:     .  ; 

4214.  Art.  4.  In  conformity  with  the  spirit  of  article  4  of  the  conveutioii. 
and  to  the  reservations  contained  In  the  protocol  of  1864,  it  is  explained  that 
for  the  appointment  of  the  charges  relative  to  the  quartering  of  troops  and  of 
the  contributions  of  war  account  only  shall  be  taken  in  an  equitable  manner 
of  the  charitable  zeal  displayed  by  the  inhabitants. 

4216.  Art.  5.  In  addition  to  article  6  of  the  convention,  It  Is  stipulated  thai, 
'with  the  reservation  of  ofllcers  whose  detention  might  be  important  to  the  fate 
of  arms  and  within  the  limits  fixed  by  the  second  paragraph  of  that  article,  the 
wounded  fallen  into  the  hands  of  the  enemy  shall  be  sent  back  to  their  country 
after  they  are  cured,  or  sooner  If  possible,  on  condition,  nevertheless,  of  not 
a^in  bearing  arms  during  the  cphtlnuance  of  the  war. 

articles  conckrnino  the  marine.,  ,,. 

4216.  Art.  6.  The  boats  which,  at  their  own  risk  attd  p'ehl,  rfurjpg  aWA  After 
an  engagement  pick  up  the  shipwrecked  Or  wounded,  or  which  paving  packed 

•The  additional  articles  now  are  generally  accepted  and  have  ncqulrcd  tho  force  and 
effect  of  ao   iDternatlonal   treaty.  ..,_.,,.  ^    „..  .  w  »w      .. 

iiThlB  JnterpreiBtlon  la  of  HpeclaJ  Importune*;  In  the  United  States,  wnero  the  term 
•ambulance"  Is  geneiaMi-  applied  to  a  veUicJe  (or  ,U»e  tr«ijspo  nation,  oIth«  alck  and 
wounded. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT/  U.    S.    KAVY.        287 

tliem  up,  convey  them  on  board  a  neutral  or  hospital  ship,  shall  enjoy,  until  the 
accomplishment  of  their  mission,  the  character  of  neutrality,  as  far  as  the  cir- 
cumstances of  the  engagement  and  the  position  of  the  ships  engaged  will  permit. 
The  appreciation  of  these  circumstances  is  intrusted  to  the  humanity  of  all 
the  combatants.  The  wrecked  and  wounded  thus  picked  up  and  saved  must 
not  serve  again  during  the  continuance  of  the  war. 

4217.  Akt.  7.  The  religious,  medical,  and  hospital  staff  of  any  captured  ves- 
sel are  declared  neutral,  and,  on  leaving  the  ship,  may  remove  the  articles  and 
surgical  instruments  which  are  their  private  property. 

4218.  Art.  8.  The  staff  designated  in  the  preceding  article  must  continue  to 
fulfill  their  functions  In  the  captured  ship,  assisting  in  the  removal  of  the 
wounded  made  by  the  victorious  party ;  they  will  then  be  at  liberty  to  return 
to  their  country,  in  conformity  vpith  the  second  paragraph  of  the  first  additional 

The  stipulations  of  the  second  additional  article  are  applicable  to  the  pay  and 
allowance  of  the  staff. 

4219.  Art.  9.  The  military  hospital  ships  remain  under  martial  law  in  all 
that  concerns  their  stores ;  they  become  the  property  of  the  captor,  but  the  latter 
must  not  divert  them  from  their  special  appropriation  during  the  continuance  of 

the  war.  .         ,  ,,  , 

4220.  Art.  10.  Any  merchant  ship,  to  whatever  nation  she  may  belong, 
charged  exclusively  with  removal  of  sick  and  wounded,  is  protected  by  neu- 
trality ;  but  the  mere  fact,  noted  on  the  ship's  books,  of  the  vessel  having  been 
visited  by  an  enemy's  cruiser,  renders  the  sick  and  wounded  incapable  of 
serving  during  the  continuance  of  the  war.  The  cruiser  shall  even  have  the 
right  of  putting  on  board  an  officer  in  order  to  accompany  the  convoy,  and  thus 
verify  the  good  faith  of  the  operation. 

,  If  the  merchant  ship  also  carries  a  cargo,  her  neutrality  will  still  protect  it. 
provided  that  such  cargo  is  not  of  a  nature  to  be  confiscated  by  the  belligerents. 
The  belligerents  retain  the  right  to  interdict  neutralized  vessels  from  all  com- 
munication, and  from  any  course  which  they  may  deem  prejudicial  to  the 
secrecy  of  their  operations.  In  urgent  cases  special  conventions  may  be  entered 
into  between  commanders  in  chief,  in  order  to  neutralize  temporarily  and  in 
a  special  manner  the  vessels  intended  for  the  removal  of  the  sick  and  wounded. 

4221.  Art.  11.  Wounded  or  sick  sailors  and  soldiers,  when  embarked,  to 
whatever  nation  they  may  belong,  shall  be  protected  and  taken  care  of  by  theii- 

captors.  ,  .  ,  ,  .  -,      ^.  ■,     r. 

Their  return  to  their  own  country  is  subject  to  the  provisions  of  article  b 
^>f  the  convention,  and  of  the  additional  article  5. 

4222.  Art.  12.  The  distinctive  flag  to  be  used  with  the  national  flag,  in  order 
to  indicate  any  vessel  or  boat  which  may  claim  the  benefits  of  neutrality,,  in 
virtue  of  the  principles  of  this  convention,  is  a  white  flag  with  a  red  cross. 
The  belligerents  may  exercise  in  this  respect  any  mode  of  verification  which 
they  may  deem  necessary.  .  , 

Military  hospital  ships  shall  be  distinguished  by  being  painted  white  outside. 

Avith  green  strake.  ,  '     '     ..  \.v, 

4223.  Art.  13.  The  hospital  ships,  which  are  equipped  at  the  expense  of  the 
aid  societies,  recognized  by  the  Governments  signing  this  convention,  and  which 
are  furnished  with  a  commission  emanating  from  the  sovereign,  who  shall  have 
o-iven  express  authority  for  their  being  fitted  out,  and  with  a  certificate  from 
the  proper  naval  authority  that  they  have  been  placed  under  his  control  during 
their  fitting  out  and  on  their  final  departure,  and  that  they  were  then  appro- 
priated solely  to  the  purpose  of  their  mission,  shall  be  considered  neutral,  as 
well  as  the  whole  of  their  staff.     They  shall  be  recognized  and  protected  by 

the  belligerents.  ' ."_  '    ^»L-.'- li' *t  i.^i' 

They  shall  make  themselves  known  by  hoisting,  togethei*  ytth  their  ■rtational 
fla<'  the  white  flag  with  a  red  cross.  The  distinctive  mark  of  their  staff  while 
performing  their  duties  Shall  be  an  armlet  of  the  same  colors.  The  outer  paint- 
ing of  these  hospital  ships  shall  be  white,  with  red  strake. 


288        MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  U.   S.    NAVY. 

These  ships  shall  bear  aid  and  assistance  to  the  wounded  and  wrecked 
belligerents,  without  distinction  of  nationality. 

They  must  take  care  not  to  Interfere  in  any  way  with  the  movements  of  the 
combatants.  During  and  after  the  battle  they  must  do  their  duty  at  their 
own  risk  and  peril. 

The  belligerents  shall  have  the  right  of  controlling  and  visiting  them.  They 
will  be  at  liberty  to  refuse  their  assistance,  to  order  them  to  depart,  and  to 
detain  them  If  the  exigencies  of  the  case  require  such  a  step. 

The  wounded  and  wrecked  picked  up  by  these  ships  can  not  be  reclaimed  by 
either  of  the  combatants,  and  they  will  be  required  not  to  serve  during  the 
continuance  of  the  war. 

4224.  Aet.  14.  In  naval  wars,  any  strong  presumption  that  either  belligerent 
takes  advantage  of  the  benefits  of  neutrality  with  any  other  view  than  the 
interest  of  the  sick  and  wounded  gives  to  the  other  belligerent,  until  proof  to 
the  contrary,  the  right  of  suspending  the  convention  as  regards  such  belligerent. 

Should  this  presumption  become  a  certainty,  notice  may  be  given  to  such 
belligerent  that  the  convention  Is  suspended  with  regard  to  him  during  the 
whole  continuance  of  the  war. 

4225.  Art.  15.  The  present  act  shall  be  drawn  up  In  a  single  original  copy, 
which  shall  be  deposited  In  the  archives  of  the  Swiss  Confederation. 

The  additional  articles  have  been  acceded  to  by  the  United  States,  and  signed 
on  behalf  of  Great  Britain,  Austria,  Baden,  Bavaria,  Belgium,  Denmark, 
France,  Netherlands,  North  Germany,  Sweden,  and  Norway,  Switzerland, 
Turkey,  and  Wurttemberg,  but  will  not  acquire  full  force  and  effect  as  an 
International  treaty  until  the  exchange  of  the  ratification  thereof  between  the 
several  contracting  States  .shall  have  been  effected. 

Section  3. — The  Geneva  Con\te:ntion  of  1906,  fob  the  Amelioration  or  thk 
Condition  of  the  Wounded  of  the  Abmies  in  the  Field. 

4231.  Signed  at  Geneva,  July  6,  1906. 
Proclaimed  August  3,  1907. 

Bt  the  President  of  the  United  States  of  America^ 

A  PROCLAMATION. 

Whereas  a  convention  between  the  United  States  of  America  and  Germany, 
the  Argentine  Republic,  Austria-Hungary,  Belgium,  Bulgaria,  Chile,  China, 
the  Congo  Free  State.  Denmark,  Spain,  Brazil,  Mexico,  France,  Great  Britain, 
Greece,  Guatemala,  Honduras,  Italy,  Japan,  Luxemburg,  Montenegro,  Norway, 
the  Netherlands.  Peru,  Persia.  Portugal.  Roumania,  Russia.  Servia.  Slam, 
Sweden,  Switzerland,  and  Uruguay,  for  the  amelioration  of  the  condition  of 
the  wounded  of  armies  In  the  field,  was  signed  at  Geneva  July  6,  1906,  the 
original  of  which  convention,  being  In  the  French  language,  Is  word  for  word 

as  follows: 

[Tranalatlon.] 

the  sick  and  wounded. 
Article  1. 

4282.  Ofllcers,  soldiers,  and  other  persons  officially  attached  to  armies,  who 
are  sick  or  wounded  shall  be  respected  and  cared  for,  without  distinction  of 
nationality,  by  the  belligerent  In  whose  power  thoy  are. 

A  belligerent,  however,  when  couipelletl  to  leave  his  wounded  in  the  hands  of 
hit  adversary  shall  leave  with  them,  so  far  a.s  miliUiry  condltlon.s  permit,  a 
portion  of  the  personnel  and  materiel  of  his  sanitary  service  to  assist  in  curing 
for  them. 


MANUAL   FOR   THE   MEDICAL  DEPARTMENT,  IT.   S.    NAVY.        289 

Abticuj  2. 

4233.  Subject  to  the  care  that  must  be  taken  of  them  under  the  preceding 
article,  the  siclt  and  wounded  of  an  army  who  fall  into  the  power  of  the  other 
belligerent  become  prisoners  of  war,  and  the  general  rules  of  international 
law  in  respect  to  prisoners  become  applicable  to  them. 

The  belligerents  remain  free,  however,  to  mutually  agree  upon  such  clauses, 
by  way  of  exception  or  favor,  in  relation  to  the  wounded  or  sick  as  they  may 
deem  proper.     They  shall  especially  have  authority  to  agree: 

1.  To  mutually  return  the  sick  and  wounded  left  on  the  field  of  battle  after 
an  engagement. 

2.  To  send  back  to  their  own  country  the  sick  and  wounded  who  have  re- 
covered, or  who  are  in  a  condition  to  be  transported,  and  whom  they  do  not 
desire  to  retain  as  prisoners. 

3.  To  send  the  sick  and  wounded  of  the  enemy  to  a  neutral  state,  with  the 
consent  of  the  latter  and  on  condition  that  it  shall  charge  itself  with  their 
interment  until  the  close  of  hostilities. 

Article  3. 

4234.  After  every  engagement  the  belligerent  who  remains  in  possession  of 
the  field  of  battle  shall  take  measures  to  search  for  the  wounded  and  to  pro- 
tect the  wounded  and  dead  from  robbery  and  ill  treatment. 

He  will  see  that  a  careful  examination  is  made  of  the  bodies  of  the  dead 
prior  to  their  interment  or  incineration. 

Article  4.  „ 

423.5.  As  soon  as  possible  each  belligerent  shall  forward  to  the  authorities  of 
their  country  or  army  the  marks  or  military  papers  of  identification  found 
upon  the  bodies  of  the  dead,  together  with  a  list  of  names  of  the  sick  and 
wounded  taken  in  charge  by  him. 

Belligerents  will  keep  each  other  mutually  advised  of  internments  and  trans- 
fers, together  with  admissions  to  hospitals  and  deaths  which  occur  among  the 
sick  and  wounded  in  their  hands.  They  will  collect  all  objects  of  personal  use, 
valuables,  letters,  etc.,  which  are  found  upon  the  field  of  battle,  or  have  been 
left  by  the  sick  or  wounded  who  have  died  in  sanitary  formations  or  other 
establishments,  for  transmission  to  persons  in  interest  through  the  authorities 
of  their  own  country. 

AjtTICLE   5. 

4230.  Military  authority  may  make  an  appeal  to  the  charitable  zeal  of  the 
Inhabitants  to  receive  and,  under  its  supervision,  to  care  for  the  sick  and 
wounded  of  the  armies,  granting  to  persons  responding  to  such  appeals  special 
protection  and  certain  immunities. 

sanitary  formations  and  establishments. 

Article  6. 

4237.  Mobile  sanitary  formations  (i.  e.,  those  which  are  intended  to  accom- 
pany armies  in  the  field)  and  the  fixed  establishments  belonging  to  the  sanitary 
service  shall  be  protected  and  respected  by  belligerents. 

Article  7. 

4238.  The  protection  due  to  sanitary  formations  and  establishments  ceases 
If  they  are  used  to  commit  acts  injurious  to  the  enemy. 

98601'— 17 19 


290        MANUAr,    FOR    THE    MKDICAI.    DEPARTMEN'JV,    U.    S.    NAVY. 

Article  8. 

4239.  A  sanitary  fonnatioii  oi-  csiublishmeut  shall  not  be  deprived  of  the 
protection  accorded  by  article  6  by  the  fact: 

(a)  Tiiat  tije  personnel  of  a  forniation  or  establishment  is  armed  and  uses 
its  arms  in  self-defense  or  in  defense  of  its  sick  and  wounded. 

(b)  Tliat  in  tlie  absence  of  arnjetl  hospital  attendants,  the  formation  is 
guarded  ))y  an  armed  detachment  or  by  sentinels  acting  under  competent  orders. 

(c)  That  arms  or  cartridges,  taicen  from  the  wounded  and  not  yet  turne(l 
over  to  the  proper  authorities,  are  found  in  the  formation  or  establishment. 

PERSONNEL. 

Article  9. 

4240.  Tlio  personnel  cluirged  exclusively  witli  the  removal,  transportation, 
nnd  treatment  of  the  sick  and  wounded,  as  well  as  with  the  administration  of 
sanitary  formations  and  establishments,  and  the  chaplains  attached  to  armies, 
shall  be  respected  and  prtjtected  under  all  circumstances.  If  they  fall  Into  the 
hands  of  the  enemy  thoy  shall  not  be  considered  as  prisoners  of  war. 

These  provisions  apply  to  the  guards  of  .sanitary  fonnations  and  establish- 
ments in  the  case  provi(1ed  for  In  section  2  of  article  8. 

4241.  The  i)er.sonnel  of  volunteei*  aid  societies,  duly  recognized  and  auihoi;- 
i/c(l  by  their  own  governments,  who  are  employed  In  the  sanitary  formations' 
and  establishments  of  armies,  are  jissimilated  to  the  personnel  contemplated 
in  the  pre<eding  article,  upon  condition  that  the  said  personnel  shall  be  sul»ject 
to  militJiry  laws  and  regulations. 

I'^ach  State  shall  make  known  to  the  other,  either  lu  tiiue  of  peace  or  at  the 
opening,  or  during  the  progress  of  hostilities,  and  in  any  case  before  actual 
employment,  the  names  of  the  societies  which  it  has  authorized  to  render 
assistance,  tmder  its  responsiliijity,  in  the  oflicial  sanitary  service  of  Its  :irmies. 

ABjclrcLE  11. 

''  4^42."  A  re'cogitf^ed  soclte^y  of  .d  neutral  State  can  only  lend  the  services  of  its 
sanitary  personnel  aiid  formatloiis  to  ii  belligerent  with  the  prior  consent  of  its 
i.wn  Oovornraent  and  the  authority  of  such  belligerent.  The  belligerent  who 
has  accepted  such  assistance  is  re<iuired  to  notify  (he  enemy  before  juaking 
any  use  thereof.  .('.::■■    . 

,     ,  ,  .       .    ,         .     .  ,     Article  12.  ,  .  ,,,  , 

4l54JJ.'1.*ei'^bns  deScribeW'jn'ai'ticles  9,  10,  andlT>vit!  continue  in  the  exerd^*;^; 
of  their  fuiicTlons,  under  the  direction  of  the  enemy,  after  they  have  fallen  lntp'| 
his  power. 

When  their  assisluuce  is  uo  longer  iiulispen.sable  lliey  will  be  .sent  back  1o 
liieir  army  or  country  within  such  period  and  by  such  route  as  may  accord 
with  military  necessity.  They  will  carry  with  them  such  effects,  instruments, 
arms,  and  liors«»s  as  are  their  private  property. 

AmcLE  13.  ,^flq 

4244.  While  they  remain  in  his  iM)\ver.  tlie  enemy  will  secure  to  the  persoimol 
mentioned  in  article  9  the  same  pay  uui^  allowances  to  which  i>ersons  of  (he 
same  grade  in  his  own  army  are  enntlecl. 

.-,  •;  .■  ';    i':-  '<1  .:      \i\i\in  ni.  J  II 


MAJSUAL   bOR    THE    MEDICAL    DEPAKTMENT,    U.    S.    NAVY,        291 

MATERIEL. 

Arttcle  34. 

4246.  If  mobile  sanitary  fermations  fall  into  tlio  power  of  the  enemy,  thoy 
Mliall  retain  their  materiel,  including  the  teams,  whatever  may  be  the  means  of 
transportation  and  the  conducting  personnel.  Competent  military  authority, 
however,  shall  have  tlie  right  to  employ  it  in  caring  for  the  sick  and  woimded. 
The  restitution  of  the  materiel  shall  lake  place  in  accordance  with  the  condi- 
tions prescribed  for  the  sanitary  personnel,  and,  as  far  as  possible,  at  the  same 
time. 

AUTICLE   15. 

4246.  Buildings  and  materiel  jiertaining  to  fixed  establishments  shall  remain 
subject  to  the  laws  of  war,  but  can  not  be  diverted  from  their  use  so  long  as 
they  are  necessary  for  the  siclt  and  wounded.  Commanders  of  troops  engaged 
in  operations,  however,  may  use  them,  in  ease  of  important  military  necessity, 
if  before  sucli  use  the  sicl?  and  wounded  who  are  in  them  have  been  provide<l 
for. 

1 
Article  16.  ■ 

.  42147.  The  materiel  of  aid  societies  admitted  to  the  benefits  of  thiSi  conven,-. 
tiOD,  in  conformity  to  the  conditions  therein  established,  is  regarded  as  private . 
property  and,  as  such,  will  be  respected  under  all  circumstances,  save  that  it 
is  subject  to  the  recognized  right  of -iSequisition  by  belligei'ents  in  conformity  to 
the  laws  and  usages  of  wai". 

■     •  .'jO;-',i!   muT  .  (Oij.T'-;' !!■■;)  ^ni    lO  '  itw  .•^li  li/irfa 

s'   .,.   .iqr  .^j.v.<,   ua<v.-       .^     ■    j^TlctElT.        ■'  ■''     '     '"'   "■'• 

4248.  Convoys  of  evacuation  shall  be  treate<l  as  mobile  sanitary  formations 
subject  to  the  following  special  provisions : 

1.  A  belligerent  intercepting  a  convoy  may,  if  required  by  military  necessity, 
break  up  such  convoy,  charging  himself  with  the  care  of  the  sick  and  wounded  , 
Avhom  it  contains.  ^; 

2.  In  this  case  the  obligation  to  return  the  sanitary  personnel,  as  provided 
for  in  article  12,  shall  be  extended  to  include  the  entire  military  personnel  em- 
ployed, under  competent  orders,  in  the  transportation  and  protection  of  the 
convoy. 

The  obligation  to  return  the  sanitary  materiel,  as  provided  for  in  article  14. 
shall  apply  to  railway  trains  and  vessels  intended  for  interior  navigation  which 
have  been  especially  equipped  for  eva«?uation  purposes,  as  well  as  to  the  ordi- 
nary vehicles,  trains,  and  vessels  which  belong  to  the  sanitary  service.  '^'^ 

Military  vehicles,  with  their  teams,  other  than  those  belonging  tt?  the  sanitnrj*"! 
service,  may  be  captured.  '>"J 

The  civil  personnel  and  the  various  means  of  transportation  obtained  by 
requisition,  including  railway  materiel  and  vessels  utilized  for  convoys,  are 
subject  to  the  general  rules  of  international  law. 

[I'  pr^TtNCa?i,V]srfiMBLEii'; 

Articxe  18.  ' 

4249.  Out  of  respect  to  Switzerland  the  heraldic  emblem  of  the  red  cross  on 
s  white  ground,  formed  by  the  reversal  of  tlie  F.ederal  colors,  is  continued  -as 
the  emblem  and  distincitire  sjgn  ,oi  th9,.^iuit^ry,,sei;y4cf^j9f  a,r^i9^^     .  j    cij'  •}■■■■  n 


292        MANUAL   FOR   THE   MEDICAL   DEPABTMENT,  XT.    S.    NAVY. 

Article  19. 

4250.  This  emblem  appears  on  flags  and  brassards  as  well  as  upon  all  ma- 
teriel appertaining  to  the  sanitary  service,  with  the  permission  of  the  compe- 
tent military  authority. 

Article  20, 

4251.  The  personnel  protected  in  virtue  of  the  first  paragraph  of  article  9, 
and  articles  10  and  11,  will  wear  attached  to  the  left  arm  a  brassard  bearing 
a  red  cross  on  a  \\hite  ground,  which  will  be  issued  and  stamped  by  competent 
military  authoi'ity,  and  accompanied  by  a  certificate  of  identity  in  the  case  of 
persons  attached  to  the  sanitary  service  of  armies  who  do  not  have  military 
uniform. 

Abticle  21. 

4252.  The  distinctive  flag  of  the  convention  can  only  be  displayed  over  the' 
sanitary  formations  and  establishments  which  the  convention  provides  shall  be 
respected,  and  Mith  the  consent  of  tbe  military  authorities.  It  shall  be  accom- 
panied by  the  national  flag  of  the  belligerent  to  whose  service  the  formation  or 
establishment  Is  attached. 

Sanitary  formations  which  have  fallen  into  the  power  of  the  enemy,  however, 
shall  fly  no  other  flag  than  that  of  the  Red  Cross  so  long  as  they  continue  In 
that  situation. 

Article  22. 

4253.  The  sanitary  formations  of  neutral  countries  which,  under  the  condi- 
tions set  forth  in  article  11,  have  been  authorized  to  render  their  services, 
shall  fly,  with  the  flag  of  the  convention,  the  national  flag  of  the  belligerent 
to  which  they  are  attached.  The  provisions  of  the  second  paragraph  of  the 
preceding  article  are  applicable  to  them. 

Article  23. 

4264.  The  emblem  of  the  red  cross  on  a  white  ground  and  the  words  Red 
Cross  or  Geneva  Cross  may  only  be  used,  whether  in  time  of  peace  or  war, 
to  protect  or  designate  sanitary  formations  and  establishments,  the  personnpl 
«nd  raat6riel  protected  by  the  convention. 

APPLICATION   AND   EXECUTION   OF  THE   CONVENTION. 
Article  24. 

4255.  The  provisions  of  the  present  convention  are  obligatory  only  on  the 
contracting  powers,  in  case  of  war  between  two  or  more  of  tliem.  The  said 
provisions  shalj  cease  to  be  obligatory  if  one  of  the  belligerent  powers  should 
not  be  signatory  to  the  convention. 

Artici,e  25. 

425(>.  It  sha'i  b(^  the  duty  of  the  cDiiiiiianders  in  chirf  of  the  belligerent 
armies  to  provide  for  the  details  of  execution  of  the  foregoing  articles,  as  well 
as  for  unfore.seen  cases,  in  accordance  with  the  Instructions  of  their  respective 
Governments,  and  conformably  to  the  general  principles  of  this  convention. 

Aktici.e  2G. 

4257.  The  signatory  (lovennncnts  shall  take  the  ncve.ssary  steps  to  acquaint 
their  troops,  and  particularly  the  protccte<l  personnel,  with  the  provisions  of 
this  convention  and  to  make  them  known  to  the  people  at  large. 


MANUAL    FOR   THE    MEDICAL    DEPARTMENT,   U.    S.    NAVY.        293 
REPRESSION    OF    ABUSES    AND    INFRACTIONS. 

Article  27. 

4258.  The  signatory  powers  whose  legislation  may  not  now  be  adequate 
engage  to  take  or  recommend  to  their  legislatures  such  measures  as  may  be 
necessary  to  prevent  the  use,  by  private  persons  or  by  societies  other  than  those 
upon  which  this  convention  confers  the  right  thereto,  of  the  emblem  or  name 
of  the  Red  Cross  or  Geneva  Cross,  particularly  for  commercial  purposes  by 
means  of  trade-marks  or  commercial  labels. 

The  prohibition  of  the  use  of  the  emblem  or  name  in  question  shall  take  effect 
from  the  time  set  in  each  act  of  legislation,  and  at  the  latest  five  years  after 
this  convention  goes  into  effect.  After  such  going  into  effect,  it  shall  be 
unlawful  to  use  a  trade-mark  or  commercial  label  contrary  to  such  prohibition. 

Aeticle  28. 

42o9.  In  the  event  of  their  military  penal  laws  being  insufficient,  the  signa- 
tory Governments  also  engage  to  take,  or  to  recommend  to  their  legislatures, 
the  necessary  measures  to  repress,  in  time  of  war,  individual  acts  of  robbery 
and  ill  treatment  of  the  sick  and  wounded  of  the  ai'mies,  as  well  as  to  punish, 
as  usurpations  of  military  insignia,  the  wrongful  use  of  the  flag  and  brassard 
of  the  Red  Cross  by  military  persons  or  private  individuals  not  protected  by 
the  present  convention. 

They  will  communicate  to  each  other  through  the  Swiss  Federal  Council  the 
measures  taken  with  a  view  to  such  repression,  not  later  than  five  years  from 
the  ratification  of  the  present  convention. 

GENERAL  PROVISIONS. 

Article  29. 

4260.  The  present  convention  shall  be  ratified  as  soon  as  possible.  The 
ratifications  will  be  deposited  at  Berne. 

A  record  of  the  deposit  of  each  act  of  ratification  shall  be  prepared,  of  which 
a  duly  certified  copy  shall  be  sent,  through  diplomatic  channels,  to  each  of  the 
contracting  powers. 

Article  30. 

4261.  The  present  convention  shall  become  operative,  as  to  each  power,  six 
months  after  the  date  of  deposit  of  its  ratification. 

I,  Aeticle  31. 

4262.  The  present  convention,  when  duly  ratified,  shall  supersede  the  con- 
vention of  August  22,  1864,  in  the  relations  between  the  contracting  States. 

The  convention  of  1864  remains  in  force  in  the  relations  between  the  parties 
who  signed  it  but  who  may  not  also  ratify  the  present  convention. 

Article  32. 

4263.  The  present  convention  may,  until  December  31,  proximo,  be  signed  by 
the  powers  represented  at  the  conference  which  opened  at  Geneva  on  June  11, 
3906,  as  well  as  by  the  powers  not  represented  at  the  conference  who  have 
signed  the  convention  of  1864. 

Such  of  these  powers  as  shall  not  have  signed  the  present  convention  on  or 
before  December  31,  1906,  will  remain  at  liberty  to  accede  to  it  after  that  date. 
They  shall  signify  their  adherence  in  a  written  notification  addressed  to  the 


294         MANUAL    FOU    TRE    MEDICAL    DEPAKIMEXT,   U.    S.    XAVY. 

Swiss  Federal  Couucil,  and  communicated  to  all  the  contractiu;;  p(»\vfis  by  the 
said  council. 

Other  powers  may  request  to  adhere  in  the  same  manner,  but  their  request 
siiall  only  be  effective  if,  within  the  period  of  one  year  from  its  notification  to 
the  Federal  council,  such  council  has  not  been  advised  of  any  opposition  on  the 
part  of  any  of  the  contracting  powers. 

Abticle  33. 

4264.  Each  of  the  contracting  parties  shall  have  the  right  to  (leiii»\uice  the 
present  convention.  This  denunciation  shall  only  become  operative  one  year 
utter  a  notification  in  writing  shall  have  been  made  to  the  Swiss  P'ederal 
C'ouiicil,  which  sliall  forthwitli  communicate  such  notification  to  all  the  other 
contracting  parties. 

This  denunciation  shall  only  become  operative  in  respect  to  the  power  which 
has  given  it. 

In  faitli  whereof  the  plenipotentiaries  have  signed  the  present  convention 
and  affixed  their  seals  thereto. 

Done  at  Geneva,  the  6th  day  of  July,  1906,  in  a  single  copy,  whicli  shall  re- 
main in  the  arciuves  of  the  Swiss  Confederation  and  certified  copies  of  which 
shall  bo  delivered  to  the  contracting  parties  through  diplomatic  channels. 

I  Ilere  follow  the  signatures.) 


UiNAl.  PROTOCOL  OF  THE  CONFKBKNCK  FOR  THE  KKViSlON   OF  THK  GKNEVA  CONVKNTION. 

4265.  The  conference  called  by  the  Swiss  Federal  Council,  with  a  \iew  to 
revising  the  international  convention  of  August  22,  1864,  for  the  amelioration  of 
the  condition  of  soldiers  wounded  in  armies  in  the  field,  met  at  (rcneva  on  June 
11.  1{K)6.  The  powers  liereinl)plow  enumerated  took  part  in  the  conference  to 
which  they  had  designated  the  delegates  hereinbelow  named. 

(Names  of  countries  and  delegates.) 
, . ;    ■      *    ^  *  *  ■  *  .]*.',-  *  fi  ,**! ' 

In  a  series  of  meetings  held  from  the  11th  of  Jime  to  the  5th  of  July.  190G,  the 
•  conference  iliscu.ssed  and  framed,  for  the  signatures  of  the  plenipotentiaries,  the 
text  of  a  convention  which  will  bear  the  date  of  July  6,  190is. 

In  addition,  and  conformably  to  article  16  of  the  convention  for  the  peaceful 
settlement  of  international  disputes,  of  July  29.  1899.  which  recognized  arbitra- 
tion as  the  most  effective  and  at  the  same  time  most  equitable  means  of  adjust- 
in;;  diffcronce.s  that  liave  not  been  rcsolvt^d  tiirougli  the  diplomatic  channel,  the 
conference  uttered  the  following  wish : 

The  conrerenci-  cxpiessod  the  wish  that,  in  order  to  arrive  at  as  exact  as 
possible  an  interpretation  and  application  of  the  Geneva  convention,  the  con- 
tracting powers  will  refer  to  the  Permanent  Court  at  The  Hague,  If  permitted 
by  the  ca.ses  and  circumstances,  such  tllfferences  as  may  arise  among  them,  in 
time  of  peace,  concerning  the  interpretation  of  the  snid  convention. 

This  wish  was  adopted  by  the  following  States: 

Germany,  Argentine  Kepubllc,  Austria-Hungary,  Belgium.  Bulgaria.  Chile, 
China,  ('ongo,  f>eninark,  Spain  (ad  referendum).  United  States  of  America. 
United  States  of  Brazil,  France,  Greece.  Guatemala,  Honduras,  Italy.  Luxem- 
burg. Montenegro,  Nicaragua,  Norway,  the  Netherlands,  Peru,  Persia.  Portugal, 
Uouinania,  Russia.  Servla.  Slam.  Sweden,  Switzerland,  and  Uruguay. 

The  wish  was  rejected  by  the  following  States: 

Corea,  (Jreat  Britain,  and  Japan. 

In  witness  whereof  the  delegates  have  signed  the  present  protocol. 

Done  at  Geneva  the  6tli  day  of  July.  19()6,  in  a  single  copy  which  shall  b© 
deposlte<l  In  the  archives  of  the  Swiss  < Confederation  and  certified  copies  of 
which  shall  be  dellvere<l  to  all  the  powers  represented  at  the  conference. 

(Signatures.) 


MANUAL   FOR   THE    MEDICAL    DEPARTMENT,    U.    S.    NAVY.        295 

Section  4. — Thk  Hague  Peace  Confekeisce  of  1899. 

4271.  Tlu!  convention  between  the  United  St.ites  and  certain  powers  for  tlie 
adaptation  to  maritime  warfare  ot  the  principles  of  the  Geneva  convention  of 
Ansnst  22,  1864,  signed  at  The  Hagne,  Jn!y  29,  1899,  and  proclaimed  November 
1.  1901.  is  as  follows : 

4272.  Article  1.  Military  hospital  ships,  that  is  to  say,  ships  constructed  or 
assigned  by  States  specially  and  solely  for  the  purpose  of  assisting  the 
Avounded,  sick,  or  shipwrecked,  and  the  names  of  which  shall  have  been  coni- 
nnmicated  to  the  belligerent  powers  at  the  beginning  or  during  the  course  of  hos- 
tilities, and  in, any  case  before  they  are  employed,  shall  be  respected  and  can  not 
be  captured  while  hostilities  last. 

These  ships,  moreover,  are  not  on  the  same  footing  as  nien-of-war  as  regards 
their  stay  in  a  neutral  port. 

4373.  Art.  2.  Hospital  ships,  equipped  wholly  or  in  part  at  the  cost  of  private 
individuals  or  officially  recognized  relief  societies,  shall  likewise  be  respected  and 
exempt  from  capture,  provided  the  belligerent  power  to  whom  they  belong  has 
given  them  an  official  commission  and  has  notified  their  names  to  the  hostile 
power  at  the  commencement  of  or  during  hostilities,  and  in  any  case  before  they 
are  employed. 

These  ships  must  be  furnished  with  a  certificate  from  the  competent  authori- 
ties, declaring  that  they  harl  been  under  their  control  while  fitting  out  and  on 
final  departure. 

4274.  Art.  3.  Hospital  ships,  equipped  wliolly  or  in  part  at  the  cost  of  private 
individuals  or  officially  recognized  societies  of  neutral  countries,  shall  be  re- 
spected and  exempt  from  capture,  if  the  neutral  power  to  whom  they  belong  has 
given  them  an  official  commission  and  notified  their  names  to  the  belligerent 
powers  at  the  commencement  of  or  during  hostilities,  and  in  any  case  before  they 
are  employed. 

4275.  Art.  4  The  ships  mentioned  in  articles  1,  2,  and  3  shall  afford  relief 
and  assistance  to  the  wounded,  sick,  and  shipwrecked  of  the  belligerents  inde- 
pendently of  their  nationality. 

The  Governments  engage  not  to  use  these  ships  for  any  military  purpose. 

These  ships  nuist  not  in  any  way  hamper  the  movements  of  the  combatants. 

During  and  after  an  engagement  they  will  act  at  their  own  risk  and  peril. 

The  belligerents  will  have  the  right  to  control  and  visit  them ;  they  can 
refuse  to  help  them,  order  them  off,  make  them  take  a  certain  course,  and  put 
a  commissioner  on  board;  they  can  even  detain  them,  if  important  circum 
stances  require  it. 

As  far  as  possible  the  belligerent.^  shall  inscribe  in  the  sailing  papers  of  thi; 
hospital  ships  the  orders  they  give  them. 

4276.  Art.  5.  The  military  hospital  ships  shall  be  distinguished  by  being 
painted  white  outside  with  a  horizontal  band  of  green  about  a  meter  and  a  half 
in  breadth. 

The  ships  mentioned  in  av-ticles  2  and  3  shall  be  distinguished  by  being 
painted  white  outside  with  a  horizontal  band  of  red  about  a  meter  and  a  half 
in  breadth. 

The  boats  of  the  ships  above  mentioned,  as  also  small  craft  which  may  hf 
used  for  hospital  work,  shall  be  distinguished  by  similar  painting.  ■'  ' 

All  hospital  ships  shall  make  themselves  known  by  hoisting,  together  with 
their  national  flag,  the  white  flag  with  a  red  cross  provided  by  the  Geneva 
convention. 

4277.  Art.  6.  Neutral  merchantmen,  yachts,  or  vessels  having  or  taking  on 
board  sick,  wounded,  or  shipwrecked  of  the  belligerents,  can  not  be  captured 
for  so  doing,  but  they  are  liable  to  capture  for  any  violation  of  neutrality  they 
may  have  comijiitted. 

4278.  Art.  7.  The  religious,  medical,  or  hospital  staff  of  any  captured  ship  is 
Inviolable,  and  its  members  can  not  be  made  prisoners  of  war.     On  leaving  the 


296        MANUAL  FOB  THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

ship  they  take  with  them  the  objects  and  surgical  instruments  which  are  tlieir 
own  private  property. 

This  staff  shall  continue  to  discharge  Its  duties  while  necessary,  and  can 
afterwards  leave  when  the  ooniniander  in  chief  considers  it  possible. 

The  belligerents  must  guarantee  to  the  staff  that  has  fallen  into  their  hands 
the  enjoyment  of  their  salaries  intact. 

4279.  Akt.  8.  Sailors  and  soldiers  who  are  taken  on  board  when  sick  or 
wounded,  to  whatever  nation  they  belong,  shall  be  protected  and  looked  after 
by  the  captors. 

4280.  Art.  9.  The  shipwrecked,  wounded,  or  sick  of  one  of  the  belligerents 
who  fall  into  the  hands  of  the  other  are  prisoners  of  war.  The  captor  must 
decide,  according  to  circumstances,  if  it  is  best  to  keep  them  or  send  them  to  a 
port  of  his  own  country,  to  a  neutral  port,  or  even  to  a  hostile  port.  In  the 
last  case,  prisoners  thus  repatriated  can  not  serve  as  long  as  the  war  lasts. 

4281.  Art.  10.    (Excluded.) 

4282.  Abt.  11.  The  rules  contained  in  the  above  articles  are  binding  only  on 
the  contracting  powers  in  case  ot  war  between  two  or  more  of  them. 

The  said  rules  shall  cease  to  be  binding  from  the  time  when,  in  a  war  be- 
tween the  contracting  jwwers,  one  of  the  belligerents  is  joined  by  a  noncontract- 
ing  power. 

4283.  Abt.  14.  In  the  event  of  one  of  the  high  contracting  parties  denouncing 
the  present  convention,  such  denunciation  shall  not  take  effect  until  a  year 
after  the  notification  made  in  writing  to  the  Netherlands  Government,  and 
forthwith  communicated  by  it  to  all  the  other  contracting  powers. 

This  denunciation  shall  only  affect  the  notifying  power. 

Section  5. — Ck)NVENTioN  Between  Certain  Powers  Regarding  the  Exemption 
OF  Hospital  Ships,  in  Time  of  War,  from  the  Payment  of  all  Dues  and 
Taxes  Imposed  fob  the  Benefit  of  the  State,  Signed  at  The  Hague  De- 
cember 21,  1904 ;  Pboclaimed  May  21,  1907. 

4291.  Article  1.  Hospital  ships,  concerning  which  the  conditions  set  forth  in 
articles  1,  2,  and  3  of  the  convention  concluded  at  The  Hague  on  July  29,  1899, 
for  the  adaptation  to  maritime  warfare  of  the  principles  of  the  Geneva  con- 
vention of  August  22,  1864,  are  fulfilled,  shall  be  exempted,  in  time  of  war,  from 
all  dues  and  taxes  imposed  on  vessels  for  the  benefit  of  the  State,  in  the  ports 
of  the  contracting  parties. 

4292.  Art.  2.  The  provision  of  the  foregoing  article  does  not  prevent  the 
application,  by  means  of  visitation  or  other  formalities,  of  fiscal  or  other  laws 
in  force  at  said  ports. 

4293.  Art.  3.  The  rule  laid  down  in  article  1  is  binding  only  on  the  con- 
tracting powers  in  case  of  war  between  two  or  more  of  them. 

The  said  rule  shall  cease  to  be  binding  from  the  time  when  a  noncontracting 
power  shall  join  one  of  the  belligerents  in  a  war  between  contracting  jwwers. 

4294.  Art.  4.  The  present  convention,  which  bearing  the  date  of  this  day, 
may  be  signed  until  the  1st  of  October,  1905,  by  the  powers  expressing  their 
desire  to  do  so,  shall  be  ratified  as  soon  as  possible.  The  ratification  shall  be 
deposited  at  The  Hague. 

A  proci's  verbal  of  the  deposit  of  the  ratifications  shall  be  drawn  up  and  a 
copy  thereof,  duly  certified,  shall  be  delivered  through  the  diplomatic  channel 
to  all  the  contracting  powers. 

4295.  Art.  H.  The  nonsigiialory  powers  are  permitted  to  adhere  to  the  iwesent 
convention  after  October  1,  1905. 

They  shall,  to  that  end,  make  their  adhislon  known  to  the  contracting  i>o\vers 
by  means  of  a  written  notification  addressed  to  the  Government  of  the  Nether- 
lands and  communicated  by  the  latter  to  the  other  contracting  powers. 


MANUAL  FOR   THE   MEDICAL   DEPARTMENT,   U.    S.    NAVY.        297 

4296.  Art.  6.  In  the  event  of  one  of  the  high  contracting  powers  denouncing 
the  present  convention,  such  denunciation  shall  not  take  effect  unti^  one  year 
after  the  notification  made  in  vpriting  to  the  Government  of  the  Netherlands  and 
immediately  communicated  by  the  latter  to  all  the  other  contracting  powers. 
This  denunciation  shall  only  affect  the  notifying  power. 

4297.  Final  act.— At  the  moment  of  proceeding  to  sign  the  convention  havini: 
for  its  object  the  exemption  of  hospital  ships  in  time  of  war  in  the  ports  of  the 
contracting  parties  from  all  dues  and  taxes  imposed  on  vessels  for  the  benefiv 
of  the  State,  the  plenipotentiaries  signing  the  present  act  express  the  wish 
that,  in  view  of  the  highly  humanitarian  mission  of  these  ships,  the  contracting 
governments  may  take  the  measures  necessary  in  order  to  exempt  these  ships 
within  a  short  time  also  from  the  payment  of  the  dues  and  taxes  collected  in 
their  ports  for  the  benefit  of  others  than  the  State,  especially  those  collected  for 
the  benefit  of  municipalities  or  of  private  companies  or  persons. 

Section  6. — Hagxje  Convention  of  Octobeb  18,  1907,  fob  the  Adaptation  of 

THE   PrINCIPI.es    OF   THE   GENEVA   CONVENTION    OF    JUI.Y    6,    1906,    TO   MABITIME 

Warfare. 

4301.  Aeticle  1.  Military  hospital  ships,  that  is  to  say,  ships  con.structed  or 
assigned  by  States  specially  and  solely  with  a  view  to  assisting  the  wounded, 
sick,  and  shipwrecked,  the  names  of  which  have  been  communicated  to  the 
belligerent  powers  at  the  commencement  or  during  the  course  of  hostilities,  and 
in  any  case  before  they  are  employed,  shaU  be  respected,  and  can  not  be  cap- 
tured while  hostilities  last. 

These  ships,  moreover,  are  not  on  the  same  footing  as  warships  as  regards 
their  stay  in  a  neutral  port. 

4302.  Art.  2.  Hospital  ships,  equipped  wholly  or  in  part  at  the  expense  of 
private  individuals  or  officially  recognized  relief  societies,  shall  be  likewise  re- 
spected and  exempt  from  capture,  if  the  belligerent  power  to  whom  they  belong 
has  given  them  an  official  commission  and  has  notified  their  names  to  the  hos- 
tile power  at  the  commencement  of  or  during  hostilities,  and  in  any  case  before 
they  are  employed. 

These  ships  must  be  provided  with  a  certificate  from  the  competent  authori- 
ties declaring  that  the  vessels  have  been  under  their  control  while  fitting  oul 
and  on  final  departure. 

4303.  Art.  3.  Hospital  ships,  equipped  wholly  or  in  part  at  the  expense  of 
private  individuals  or  officially  recognized  societies  of  neutral  countries,  shall 
be  respected  and  exempt  from  capture,  on  condition  that  they  are  placed  under 
the  control  of  one  of  the  belligerents,  with  the  previous  consent  of  their  own 
Government  and  with  the  authorization  of  the  belligerent  himself,  and  that 
the  latter  has  notified  their  name  to  his  adversary  at  the  commencement  of  or 
during  hostilities,  and  in  any  case  before  they  are  employed. 

4304.  Art.  4.  The  ships  mentioned  in  articles  1,  2,  and  3  shall  afford  relief 
and  assistance  to  the  wounded,  sick,  and  shipwrecked  of  the  belligerents  with- 
out distinction  of  nationality. 

The  Governments  undertake  not  to  use  these  ships  for  any  military  purpose. 

These  vessels  must  in  no  wise  hamper  the  movements  of  the  combatants. 

During  and  after  an  engagement  they  will  act  at  their  own  risk  and  peril. 

The  belligerents  shall  have  the  right  to  control  and  search  them;  they  can 
refuse  to  help  them,  order  them  off,  make  them  take  a  certain  course,  and 
put  a  commissioner  on  board ;  they  can  even  detain  them,  if  important  circum- 
stances require  it. 

As  far  as  possible,  the  belligerents  shall  enter  in  the  log  of  the  hospital  ships 
the  orders  which  they  give  them. 

4306.  Art.  5.  Military  hospital  ships  shall  be  distinguished  by  being  painted 
white  outside  with  a  horizontal  band  of  green  about  a  meter  and  a  half  in 
breadth. 


296        MANUAL   1<'0K   THE   MEDICAL  DEPARTMENT,   U.    S.    NAVY. 

The  ships  Hientiouetl  in  articles  2  and  3  shall  be  distinguished  by  being 
painted  wiiite  outside  with  a  horizontal  band  of  red  about  a  meter  and  a  lialf 
in  breadth. 

The  boats  of  the  ships  above  mentioned,  as  also  small  craft  which  may  be 
used  for  hospital  work,  shall  be  distinguished  by  similar  painting. 

All  hospital  ships  shall  make  themselves  known  by  hoisting,  with  their 
national  flag,  the  white  flag  with  a  red  cross  provided  by  the  Geneva  convention, 
ami  further,  if  they  belong  to  a  neutral  State,  by  flying  at  the  mainmast  the 
national  flag  of  the  belligerent  under  whose  control  they  are  placed. 

Hospital  ships  which,  in  the  terms  of  article  4,  are  detained  by  the  enemy, 
must  haul  down  the  national  flag  of  the  belligerent  to  whom  they  belong. 

The  ships  and  boats  above  mentioned  which  wish  to  insure  by  niglit  the  free- 
dom from  Interference  to  which  they  are  entitled  must,  subject  to  the  assent 
of  the  belligerent  they  are  accompanying,  take  tiie  necessary  measures  to  render 
their  special  painting  sufficiently  plain. 

4306.  Abt.  6.  The  distinguishing  signs  referred  to  in  article  5  can  only  be 
used,  whether  in  time  of  peace  >r  war,  for  protecting  or  indicating  the  ships 
therein  mentioned. 

4307.  Abt.  7.  In  the  case  of  a  tight  on  board  a  warship,  tlie  sick  wards  shall 
l)e  respected  and  spared  as  far  as  possible. 

The  said  sick  wards  and  the  material  belonginj:  to  them  remain  subject  to 
the  laws  of  war ;  they  can  not.  however,  be  used  for  any  purpose  other  than 
that  for  which  they  were  originally  intended,  so  long  as  they  are  required  for 
the  sick  and  wounded. 

The  commander,  however,  into  whose  power  they  have  fallen  may  apply  them 
to  other  purposes,  if  tlie  military  situation  requires  it,  after  seeing  that  the 
sick  and  wounded  on  board  are  jjroperly  provided  for. 

4308.  Art.  8.  Hospital  ships  and  sick  wards  of  vessels  are  no  longer  entitled 
to  protection  if  they  are  employed  for  the  purpose  of  injuring  the  enemy. 

The  fact  of  the  staff  of  the  said  ships  and  sick  wards  being  armed  for  maln- 
taiiung  order  and  for  defending  the  sick  and  wounded,  and  the  presence  of 
wireless  telegraphy  apparatus  on  board,  is  not  a  sutticient  reason  for  with- 
drawing protection. 

4309.  Abt.  9.  Belligerents  may  appeal  to  the  charity  of  the  commandeis  of 
neutral  merchant  ships,  yachts,  or  boats  to  take  on  board  and  tend  the  sick 
and  wounded. 

Vessels  responding  to  tliis  appeal,  and  also  vessels  wliich  have  of  their  own 
accord  rescued  sick,  woundeii.  or  shipwrecked  men,  shall  enjoy  special  protec- 
tion and  certain  immunities.  In  no  case  can  they  be  captured  for  having  such 
fiersons  on  board,  but,  apart  from  special  undertakings  that  have  been  made 
to  them,  they  remain  liable  to  capture  for  any  violations  of  neutrality  they  may 
have  conunitted. 

4310.  Abt.  10.  The  religious,  medical,  and  hospital  staff  of  any  capturetl  sliip 
is  Inviolable,  and  its  nuMnl)ers  can  not  be  matle  prisoners  of  war.  On  leaving 
the  sliip  they  tak»>  away  with  them  the  objects  and  surgical  instruments  which 
arc  their  own  private  property. 

This  staff  shall  continue  to  discharge  Its  duties  while  necessary,  and  can 
afterwards  leave,  when  the  commander  In  chief  considers  it  possible. 

The  belligerents  must  guarantee  to  the  said  staff,  when  it  lias  fallen  into  their 
hands,  the  same  allowances  and  pay  which  are  given  to  the  staff  of  correspond- 
ing rank  in  their  own  navy. 

4811.  Anr.  11.  Sailors  and  soldiers  on  board,  when  sick  or  wounde<i,  as  well 
as  other  perscpiis  nUicially  attached  to  fleets  or  armies,  whatever  their  mition- 
.-ilily.  shall  be  resi)e<'te<l  and  tended  by  tlu^  captors. 

4312.  AuT.  1*2.  Any  warsldp  belonging  to  a  belligerent  may  demand  that  sick, 
wonnded,  or  shlpwre<'ke<l  men  on  board  military  hospital  ships,  hospital  ships 
belonging  to  relief  societies  or  to  private  Individuals,  merchant  ships,  yachts, 
or  boats,  whatever  the  nationality  of  the.><e  ves.sels,  should  be  handed  over. 


MANUAL    FOR    THE    MEDICAL    DEJPARTMENT,    U.    S.    NAVV.        299 

4313.  Art.  IS.  If  sick,  wounded,  or  shipwrecked  persons  are  taken  on  boanl 
a  neutral  warship,  every  possible  precaution  must  be  taken  that  they  do  not 
awiu  take  part  in  the  operations  of  the  war. 

4314.  Akt.  14.  The  .shipwrecked,  wounded,  or  sick  of  one  of  the  belligerents 
who  fall  into  the  power  of  the  other  belligerent  are  prisoners  of  war.  The 
captor  must  decide,  according  to  the  circumstances,  whether  to  keep  them,  send 
rheni  to  a  port  of  his  own  country,  to  a  neutral  port,  or  even  to  an  enemy  port. 
In  this  last  case  prisoners  thus  repatriated  can  not  serve  again  while  tlie  war 
lasts. 

4315.  Akt.  15.  The  shipwrecked,  sick,  or  wounded,  who  are  landed  at  a  neu- 
tral port  with  the  consent  of  the  local  authorities  must,  unless  an  arrangemen! 
is  made  to  the  contrary  between  the  neutral  State  and  the  belligerent  States, 
be  guarded  by  the  neutral  State  so  as  to  prevent  their  again  taking  part  in  the 
operations  of  the  war. 

The  expenses  of  tending  them  in  hospital  and  interning  them  shall  be  borne 
by  the  State  to  which  the  shipwrecked,  sick,  or  wounded  persons  belong. 

4316.  Art.  16.  After  every  engagement,  the  two  belligerents,  so  far  as  mili- 
tary interests  permit,  shall  take  steps  to  look  for  the  shipwrecked,  sick,  and 
wounded,  and  to  protect  them,  as  well  as  the  dead,  against  pillage  and  ill- 
treatment. 

They  shall  see  that  the  burial,  whether  by  land  or  sea,  or  cremation  of  the 
dead  shall  be  preceded  by  a  careful  examination  of  the  corpse. 

4317.  Art.  17.  Each  belligerent  shall  send,  as  early  as  possible,  to  the 
authorities  of  their  country,  navy  or  army,  the  military  marks  or  documents 
of  identity  found  on  the  dead  and  the  description  pf  the  sick  and  wounded 
picked  up  by  him.  •-    . 

The  belligerents  shall  keep  each  other  informed  as  to  iuternntents  and  trans- 
fers as  well  as  to  the  admissions  into  hospital  and  deaths  which  have  occurred 
among  the  sick  and  wounded  in  their  hands.  They  shall  collect  all  the  objects 
of  personal  use,  valuables,  letters,  etc.,  which  are  found  in  the  captured  ships 
or  which  have  been  left  by  the  sick  or  wounded  \\ho  died  in  hospital,  in  order 
to  have  them  forwarded  to  the  persons  concerned  by  the  authorities  of  their 
own  country. 

4318.  Art.  IS.  The  provisions  of  the  present  conventioj^  do  not  apply  except 
Ijetween  contracting  powers,  and  then  only  if  all  the  belligerents  are  parties  to 
the  convention. 

4310.  Art.  19.  Tlie  commanders  in  chief  of  the  belligerent  fleets  must  see 
that  the  above  articles  are  properly  carried  out:  they  will  have  also  to  see  to 
cases  not  covered  thereby  in  accordance  with  the  instructions  of  their  respective 
(governments  and  in  conformity  with  the  general  principles  of  the  present 
convention. 

4320.  Art.  20.  The  signatory  powers  shall  take  the  necessary  measures  for 
bringing  the  provisions  of  the  present  convention  to  the  knowledge  of  their 
naval  forces,  and  especially  of  the  members  entitled  thereunder  to  immunity, 
and  for  making  them  known  to  the  public. 

4321.  Art.  21.  The  signatory  powers  likewise  undertake  to  enact  or  to  pro- 
pose to  their  legislatures,  if  their  criminal  laws  are  inadequate,  the  measures 
necessary  for  checking  in  time  of  war  individual  acts  of  pillage  and  ill-treatment 
in  respect  to  the  sick  and  wounded  in  the  fleet,  as  well  as  for  punishing,  as  an 
unjustifiable  adoption  of  naval  or  military  marks,  the  unauthorized  use  of  the 
distinctive  marks  mentioned  in  article  5  by  vessels  not  protected  by  the  present 
convention. 

They  will  communicate  to  each  other,  through  the  Netherlands  Government, 
the  enactments  for  preventing  such  acts  at  the  latest  within  five  years  of  the 
ratification  of  the  present  convention. 

4322.  Art.  22.  In  the  case  of  operations  of  war  between  tlie  laud  and  sea 
forces  of  belligerents,  the  provisions  of  the  present  convention  do  jiot  apply 
except  between  the  forces  actually  on  board  ship. 

4323.  Art.  23.  The  present  convention  shall  be  ratified  as  soon  as  possilde. 


300        MANUAL   FOR   THE   MEDICAL   DEPABTMENT,   U.    S.    NAVY. 

The  ratifications  sliall  be  deposited  at  The  Hague. 

The  first  deposit  of  ratifications  shall  be  recorded  in  a  proces  verbal  signed 
by  the  representatives  of  the  powers  taking  part  therein  and  by  the  Netherlands 
minister  for  foreign  affairs. 

Subsequent  deposits  of  ratifications  shall  be  made  by  means  of  a  written 
notification  addressed  to  the  Netherlands  Government  and  accompanied  by  the 
Instrument  of  ratification. 

A  certified  copy  of  the  proems  verbal  relative  to  the  first  deposit  of  ratifica- 
tions, of  the  notifications  mentioned  in  the  preceding  paragraph,  as  well  as  of 
the  instruments  of  ratification,  shall  be  at  once  sent  by  the  Netherlands  Gov- 
ernment through  the  diplomatic  channel  to  the  powers  invited  to  the  Second 
Peace  Conference,  as  well  as  to  the  other  powers  which  have  adhered  to  the 
convention.  In  the  cases  contemplated  in  the  preceding  paragraph  the  said 
Government  shall  inform  them  at  the  same  time  of  the  date  on  which  it  received 
the  notification. 

4324.  Akt.  24.  Nonsignatory  powers  which  have  accepted  the  Geneva  con- 
vention of  the  6th  July,  1906,  may  adhere  to  the  present  convention. 

The  power  which  desires  to  adhere  notifies  its  intention  to  the  Netherlands 
Government  in  writing,  forwarding  to  it  the  act  of  adhesion,  which  shall  be 
deposited  in  the  archives  of  the  said  Government. 

The  said  Government  shall  at  once  transmit  to  all  the  other  powers  a  duly 
certified  copy  of  the  notification  as  well  as  of  the  act  of  adhesion,  mentioning 
the  date  on  which  it  received  the  notification. 

4325.  Abt.  25.  The  present  convention,  duly  ratified,  shall  replace  as  between 
contracting  powers,  the  convention  of  the  29th  of  July,  1899,  for  the  adaptation 
to  maritime  warfare  of  the  principles  of  the  Geneva  convention. 

The  convention  of  1899  remains  in  force  as  between  the  powers  which  signed 
it,  but  which  do  not  also  ratify  the  present  convention. 

4326.  Abt.  26.  The  present  convention  shall  come  into  force,  in  the  case  of 
the  powers  which  were  a  party  to  the  first  deposit  of  ratifications,  60  days  after 
the  date  of  the  proems  verbal  of  this  deposit,  and,  in  the  case  of  the  powers  which 
ratify  subsequently  or  which  adhere  60  days  after  the  notification  of  their  rati- 
fication or  of  their  adhesion  has  been  received  by  the  Netherlands  Government. 

4327.  Abt.  27.  In  the  event  of  one  of  the  contracting  powers  wishing  to  de- 
nounce the  present  convention,  the  denunciation  shall  be  notified  in  writing  to 
the  Netherlands  Government,  which  shall  at  once  communicate  a  duly  certified 
copy  of  the  notification  to  all  the  other  powers,  informing  them  at  the  same  time 
of  the  date  on  which  it  was  received. 

The  denunciation  shall  only  have  effect  in  regard  to  the  notifying  power,  and 
one  year  after  the  notification  has  reached  the  Netherlands  Government. 

4828.  Abt.  28.  A  register  kept  by  the  Netherlands  ministry  for  foreign  affairs 
shall  give  the  date  of  the  deposit  of  ratifications  made  in  virtue  of  article  28, 
paragraphs  3  and  4,  as  well  as  the  date  on  which  the  notifications  of  adliesion 
(art.  24,  par.  2)  or  of  denunciation  (art.  27,  par.  3)  have  l)een  received. 

Bach  contracting  party  is  entitled  to  have  access  to  this  register  and  to  be 
supplied  with  duly  certified  extracts  from  it. 

In  faith  whereof  the  plenipotentiaries  have  appended  their  signatures  to  the 
present  convention. 

Done  at  The  Hague,  the  18th  of  October,  1907,  in  a  single  copy,  whic^j  shall 
remain  deposited  in  the  archives  of  the  Netherlands  Government,  and  duly  cer- 
tified copies  of  which  shall  be  sent,  through  the  diplomatic  channel,  to  the 
powers  which  have  been  invited  to  the  Second  Peace  Conference. 

Section  7. — The  Amkkican  National  Kku  Cross. 

Legislation  "  to  provide  for  the  use  of  the  American  National  Red  Cross  in 
aid  of  the  land  and  naval  forces  in  time  of  actual  or  threatened  war." 

4381.  Be  it  enacted,  etc.,  That  whenever  in  time  of  war,  or  when  war  is 
Imminent,  the  President  may  deem  the  cooperation  and  u.se  of  the  .\ft7erican 


MANUAL  FOR   THE    MEDICAL   DEPARTMENT,   U.    S.    NAVY.        301 

National  Red  Cross  with  tlie  sanitary  services  of  the  land  and  naval  forces  to 
be  necessary,  he  is  authorized  to  accept  the  assistance  tendered  by  the  said 
Red  Cross  and  to  employ  the  same  under  the  sanitary  services  of  the  Array  and 
Navy  in  conformity  with  such  rules  and  re^ilations  as  he  may  prescribe. 

Sec.  2.  That  when  the  Red  Cross  cooperation  and  assistance  with  the  land 
and  naval  forces  in  time  of  war  or  threatened  hostilities  shall  have  been  ac- 
cepted by  the  President,  the  personnel  entering  upon  the  duty  specified  in  sec- 
tion 1  of  this  act  shall,  while  proceeding  to  their  place  of  duty,  while  serving 
thereat,  and  while  returning  therefrom,  be  transported  and  subsisted  at  the 
cost  and  charge  of  the  United  States  as  civilian  employees  employed  with  the 
said  forces,  and  the  Red  Cross  supplies  that  may  be  tendered  as  a  gift  and 
accepted  for  use  in  the  sanitary  service  shall  be  transported  at  the  cost  and 
charge  of  the  United  States.     (Approved,  April  24,  1912.) 

Section    8. — Navy   Regulations    Relating   to   the   American    National 

Red  Cross. 

4341.  Red  Cross  units  and  naval  sanitary  forces.    R  3861  (1). 

4342.  War  services  to  Navy.    R  3861  (2). 

4343.  Subject  to  military  laws.    R  3861  (3). 

4344.  Assignment  of  Red  Cross  personnel.    R  3861  (4). 

4345.  Red  Cross  not  to  form  independent  hospital.    R  3861  (5). 

4346.  Red  Cross  establishment  and  naval  patients.    R  3861  (6). 

4347.  Qualification  for  service  determined  by  medical  officer.    R  3861  (7). 

4348.  Personnel  called  for.    R  3861  (8). 

4349.  Classes  of  personnel.    R  3861  (9). 

4350.  Branches  of  Red  Cross  service.    R  3861  (10). 

4351.  Red  Cross  organization  on  medical  transports  and  hospital  ships. 
R  3861   (11). 

4352.  Service  at  sanitary  base  or  naval  hospital.    R  3861  (12), 

4353.  Training  of  transport  divisions.    R  3861  (13). 

4354.  Training  of  hospital  divisions.    R  3861  (14). 

4355.  Information  bureau  division.    R  3861  (15). 

4356.  Register  of  Red  Cross  organizations.    R  3861  (16). 

4357.  Application  for  registration.    R  3861  (17). 

4358.  Application  submitted  annually.    R  3861  (18). 

4359.  Transportation  of  Red  Cross  personnel.    R  3861  (19), 

4360.  Quarters  while  in  active  service.    R  3861  (20). 


INDEX. 

Abbreviations:  Paragrapli. 

for  grades  and  rates 2241 

on  margin  of  health  record 2284 

Abdomen,  first-aid  care  of  wounds  of lOKi 

Absence : 
iPAve  of — 

applications  for,  civil  employees y.jg^ 

because  of  contagious  disease  in  family 2130 

blank  request  for 3yg2 

chief  nurse i^^ 

death  wh ile  on ^ .•...■..,.. 2435 

employees  at  hospitals , , -jv. 1541 

entered  in  journal ,  .<. •.-...■..•. i3(i2 

extension  for  illness 2129 

Nurse  Corps ,...,..,,,,,.,.: oM-689,7U2 

request  for  extension  by  telephone 1503 

•  medical  olFicer,  next  in  command  succeeds , ,^30 

Absence  and  pay mo^^vu^.  ,^. 2S20 

Absentees: 

clothing  and  property ,  care  of r  ::;  j  :;  -  ::  r  ::  -  -  t  t  -  •  -  r  .:  r  =  -  =  :.  =  -.  =  j  >■-.,,,. ,'Vi E-llit'i 

I  ^  reported — 

by  executive  surgeon .?..-.-. i;iyi 

I  by  ward  nmse j4gQ 

to  master  at  arms 1434 

Abstract: 

dental  treatment 2270 

,    enlistments  (Form  X) 3922, 3(t51, 4121, 4131 

•    health  record — 

entries  on 02.53^  2261 

procedure  on  promotion 2262 

procedm-e  on  reenlistment 2261  2281 

patients,  quarterly  (Form  F). -  •  .i.ii.i.s,j»sevj.:3a22,3936,412M131 

syphilitic  treatment '. _    93,)7 

Abuses: 

executive  smgeon  to  correct .;,.._. ._..,,,,. >io<4OT<;-sK-rf93tfe 1309 

jcpression  of .■.-.-.-,-.-.-•.-,-.-,-.-.-.-.-.■.-.•.■.-.•.-- -_-..-.-. -.-.-.-.-.-.-.-y 4258, 4259 

Academic  Board,  medical  officer  member  of .... ....._._... .... ._.j.to<5.<»-  ssi^iffimiH- 938 

Academy,  Naval.     (See  Naval  Academy.) 

Accepted  applicants,  entry  on  Form  X 20.K 

Accidental  death: 

board  of  inqviest  ordered 2419  2814 

court  of  mquiry 2426^  2814 

Accidents: 

ambulance  parties  prepared  for..... .................  .^.j^.  .a^pj^.jj.^gj^^.  r^^ 1^54 

eyewitnesses,  report  on '... .....\. ,,.,..  Ji8i6,3756 

ji  ,.in  absence  of  medical  officer .- V-  ^ -■- .    3756 

;   noted  on  health  record j.vii.-.  .;■.■■....    2209 

to  employee,  report  of ^  ;f-a-f - 2171 

AccountabiUty  for  property... -.--.-.-.-.•.-  ---.-- .................  ,Vk,j.i. .,.  ..J -^afU,  3521-3525 

ji-dental... ■-■■.■.■.■--.-.--.■.■.■■.■^.-r-^^^^-iiH'^ 1027 

5(i«xpended. -.-.■...-...........-.-..-.•.-.•.•.-.-.-.•.-.-.■.-.-.4*>s 965 

U  hospitals .........^..............^,.,^,......\.. , wi ,..;,,., .  .;,.,..-.• .  - 1257 

J-  instructions  relating  to. . . . .,..,.. . . ....... . . .... ..................................«qjy>sfl:MM-,4wtf>T-  •  -- 3511 

fi  cards  for -.-.v.V.-.-.v.v.v/////r//.-r.-.-.-^.-.r/.-.-^.:^...r^^.r^^.-r^^^^^^^.,r;r  :««?«<■=  -»- -  '     3970 

^'  ; bstioqai  ecf  oJ  ,:.'.';ii;gQg^  ij jfflo 


304  INDEX. 

Paragraph. 

Accounting  system,  hospital 1385-1415 

Accounts:  .  /  J  ll  /I  I 

deceased  persons 2406 

expenditures  to  be  specified  in 31 

hospital  ship 1 725' 

master ; .- 1726 

on  designated  vessel ...-/.I.; 1724 

men  transferred 2989, 3002 

Acids: 

carbolic — 

crude,  as  insecticide 2781 

disinfection  by 27.>5, 2765 

care  of 903 

Act,  compensation: 

instructions  relating  to ^...,., 2171 , 21 76 

payments  under ,^,,:^. 2ie*,21C.8 

physical  examination  under , 2121-2132, 21G1-217C 

Acting  appoiatment-s: 

as  hospital  apprentice,  first  class 4G4, 523 

as  hospital  steward 511 

expiring  in  hospital 1263 

Acting  assistant  dental  surgeon: 

age  of  candidal  e  for 1965 

for  temporary  service ; 323, 341 

promotion  of 32o 

Acting  assistant  surgeon: 

appointment  of 114, 151, 1903 

physical  examination  for 1929 

temporary  service 115 

Action: 

adequacy  of  arrangements  for §91 

casualty  in,  key  letter  for 2335 

dut  ies  of  surgeon's  division  during 985 

report  of  casualties  in .• 1816, 3922, 3941, 4111, 4121 

Active  duty 131 

Adenoids,  candidate  rejected  for 1981 

Address: 

fonvarding — 

noted  on  discharge  report .•.-.-.  .'.'?J.'V.'.^  i .'?;'.' 1467 

patient  to  leave 1 ,126 

next  of  kin  on  admission  report H67 

Adjutant,  post  of,  in  parades,  etc 1 854 

Administration:  ''      "n  i  iio  oJ"  '  ■'»'■ 

hospit,!il  ship,  controlled  by  Bureau  of  Medicine  and  Surgery '. 1701 

Nurse  Corps .-..•..•.■.■. .•. 611 

Admission-s : 

abbreviation  used  for 2284 

Army  and  Navy  Hospital,  Hot  Springs,  Ark i .'. ;i*.'<.'.".L . .'.  .'J.i. ; . .  1601-1622 

candidates  for — 

age  of ; 1965 

merit  roll  of 1944, 4131 

statement  under  oath 195S 

employees,  to  naval  hospitals 2174 

entered  on  abstract  of  health  record 2261 

foreign  hospital,  certificate  of 905 

merit  rol  I  of  candidates  for 1944, 41:<1 

miscondtict  report,  Marine  Corps 1242, 1365, 3915, 3922. 3972, 4131 

to  Naval  Home 1631-1632 

officer  as  patient,  to  1)0  reported 4131 


INDEX.  305 


Admission-s— Continued.  Paragraph. 

])aticnt — 

entered  in  journal .:i>P.lill.-4  i: 1362 

regulations  relating  to ....;.!... 13G5 

ration  notice  (Form  S) i^J.ivl'i: .-.  .■  3'>22, 3948,4131 

reports  kept  by  ward  nurse 1467 

supernumeraries,  report  of 4131 

venereal  cases,  required 2252 

Adults,  table  of  measurements  for 2082 

Advertisements : 

for  proposals 3302, 3372 

purchase  without 3307 

Advisory  circular 2252 

Affidavit  upon  death  or  injury 2164 

Age: 

applicant  for  enlistment 2027 

assistant  surgeon 113 

candidate  for  admission — 

Naval  Academy 1974 

various  corps 1965 

entered  on  descriptive  list 132,2103 

recruit 947 

Aid: 

first.    (S€e  "First  aid.") 

medical,  to  persons  not  in  the  Navy ^  ^ 899 

societies  (see  "Red  Cross")—  n: 

hospital  ships,  regulations  for ..-......- 4223 

regulations  concerning 4241-4244 

stations- 
battalion  singeon  to  establish 1844 

regimental M^y.'Siyi'. 1862,1864 

temporary 1866 

to  wounded,  by  inhabitants 4206 

Aides,  posts  of,  in  parades,  etc 1854 

Airing  of  bedding  weekly 254^ 

Alaska,  care  of  insane  in 3164 

Albumin,  urine  of  candidate  examined  for 1955, 1993 

Alcoholic  indulgence 2820 

Alcoholic  liquors: 

loss  of  pay  for  disability  resulting  from  use  of . : 804, 832, 924 

not  allowed  in  wards 1515 

Alcoholics,  not  to  be  enlisted 2063 

Alcoholism,  rejection  for 2113 

Allegiance,  oath  of,  applicant  takes 2081 

Allotments  on  transfer  to  hospital 2988 

Allowance- s:  

baggage,  expeditionary  force :Vk  K'.SI'i'. 1847 

clothing.  Hospital  Corps .,    1847 

fuel,  temperature  certificate 920 

medical  stores 860 

Naval  Home,  inmates  of 1633 

Nurse  Corps- 
quarters  of 751 

superintendent  of 730, 751 

Ambulance:  [TOjain*,, 

book : 4131 


806  INDEX. 

Ambulance— Continued.  Paragraph. 

definition  of  term l>»tlKL':w  J-e.  ^. . . .    4213 

distinctive  flag  for • •  •  - •*208 

equipment  retained  after  capture - • ^205 

neutrality  of -^^^^ 

;  persons  employed  in , 42n:i-4205 

party- 
armed  against  savage  enemy "^-5 

armed  escort  for ^^^^ 

equipment  of *®*^ 

instruction  of,  in  first-aid 1804,1823 

not  massed  in  parades ^'^ 

organization  of ■ ^^^ 

parades,  prepared  for  first-aid 1854 

regimental,  in  engagement -yuiijii.  jcJii-i w».si.~;i.-'--1868 

weapons  not  carried  by W** 

personnel,  duties  continued  after  capture 4212 

service — 

for  civil  employees - 1240,2173 

I)erformed  by  Hospital  Corps. „...-.^u 402,435,1261 

special  trips - ^^^ 

Analysis:  --- 

expenditures  in  bill  book 1^^^ 

urine  required  in  physical  examination 1955, 1993 

^^f^r JJ.  .bin  Jiiii'J.'.'.vv- 852 

Anatomy,  instruction  in 1^"^ 

Anchor,  removal  of  mud  from 2611 

Anchorage  in  infected  ports 2523,  260d 

Antitoxins,  obtained  from  Bure^iu  of  Medicine  and  Surgery 3563 

Antityphoid  inoculations,  intervals  between 2612 

Apparatus:  — 

electrical,  requisitions  for .^.. .^^...  ..^...^^ 3421 

finger-print,  supplied  by  Bureau  of  Navigation 2096 

fire,  care  of ■  - —  - jjji;.';;:tii. *>.,.- -i 1-321 

sterili/.ing,  care  of •>-  .^~^^.^^-. •" ^350 

Appliances:  

first-aid—  ■ 

distribution  of ;Luui;j.  ji.t'ii lsia-1821 

instruction  in  use  of -'->^- ^^^ 

surgical — 

replaceable  only  after  survey .i:i^..i:^.^.i:i'-A: 2951 

»  S6'' 

survey  of '^  - 

Applicant : 

accepted,  entry  on  Form  X 2053 

expenses  of,  no  allowance  for ■  258, ai8,357,486 

for  employment — 

physical  examination  of 2121-2123,2141-2156 

preference  for  disability  in  line  of  duty .5;'.  ;■..-:".'.. •    2132 

-,^        preference  for  honorable  discharge .._._.__._.,.__..._.. 2132 

,..,, lor  enlistment —  

adaptability  to  be  considered J'|..j,2066 

age  of ...:... .. ......... :::::.. ....^...^ . .  2027 

examination  of "'"* 

liospital  treatment  of ^^ 

for  3)cnsion,  examined  by  medical  offlcer.V.vr.V.V. .  3.58 
Application: 

appointment  Medical  Reserve  Corps.  .  '3- 

for— 

leave, civil  employee*.  ..-.•.-.•.. ...-.-.-.-.-.-r.-.-.-.-.-.-.-.-.-.-.-.-.-.%  -  '^^ 

I)enslons ; .:.............  ^33 

registration  by  Hed  Cross > ^^' 


INDEX. 


307 


.     .  Paragraph. 

Appomtment-s: 

acceptance  of Vu'u'r'Wi  lanl 

acting  assistant  surgeon 114-110,151,1903 

acting—  464  r,23 

hospital  apprentice,  first  class rTi 

chief  pharmacist's  mate -  - "' 

1 '  ■  age  of  candidates  for - - — ;  ••;;■,■," ' 

Vt""  assistant  paymaster •  -  ■ 

assistant  surgeon -  ■  •  "■'.'.'.'.'.".' '  " ' ".'''"  '"• ,Qr  i 

06^  candidates  to  have  physical  examination -  ■ .  -  -  -"-  ■-•--' -  ■  -  -  -  •;.-;;.•;;.■.•.•.:•  * "       "^^ 

>'    chaplauis , 

chief  of  Bureau  of  Medicineand  Svu-gery '{^-giufi'hn 

chiefsofbureaus •- - ;;;;  ;m:3i3; 332-335 

Dental  Corps '  ^.,^.q 

Dental  Reserve  Corps 

•      fleet  surgeon 

hospital  ships,  regulations  for ::::::: '^i'' ' ' '    Jang 

^     Marme  Corps  officers - ----■ - '''■'■■■■■■■-'■■  'xU\^'m'm--li/2 

0*.    Medical  Reserve  Corps. :...;..... -'..;';.    o^f 

,.„..,  241,2.)l-255 

qualifications  for • ;.V.V  ."■'•'''•*•'■  ^nm 

(•''    naval  constructors ::":::::::' .^-,  273 

'•      Naval  Militia,  medical  corps  of '.■.".VioTr'      ' n  c\A  ''41-647 

'•      Nurse  Corps ■•.■^■(^;■MOVlt.;■^iiiii;Li>■;?-''^    'J^g^_ggg 

'■'  chief  nurse - " -■":'.* 

superintendent .".■■.■.■.■.■.■.".■.'.■"." '  "."."■'.'  '■' n.^a 

<^'     nurse,  revocation  of ■-- ■' ;^-., ' 

■ '     officers,  by  President,  with  advice  of  Senate.-. ■.'. - •  ■  -    ^ 

health  record  to  he  opened ^"''^'  "^ 

permanent—  ,„ 

^  405,523 

2,503 

1906 


hospital  apprentice,  first  class . 

,  ., 442, oOo 

pharmacist.  


^"   professor  of  mathematics —  ']l[['llillimill^^~''^'  '■  — 

-' '    subject  to  examination .........".■. .^^. ^. ^^.^.^^^f^. . ■y^jj' ,-oiffiy^ 

subject  to  physical  examination ........".■.■...-■.■. :.:■■•-■ .: "'"'      ?m 

surgeon ■ ■ 'wno-m 

termination  of,  disposition  of  health  record ^-"'007= 

Appraisal  of  articles  to  be  sold • 29oo,2975 

Apprentice:  2084 

-     musician,  physical  proportions  of. .. . .-. :■■".■■.""■■::.■:.";; .'o J ov'c'avisM^""' ' "''' ' ivjoi 

'      seaman,  physical  proportions  of.  .-..•.  v.-. -.--•.•-".•...•.... ".■...■. yr-^e',^rf9\ 

Approprlatiou-s:  1397-1400,3383,3400 

charges  against .•■;.  ..  70 \dnn\dTi 

contingent.  Bureau  of  Medicine  and  Surgerj-- ••• /^,i4w,MM 

...       ,  •       ■ 51-Ca 

laws  relating  to  ■-■■• 72,3383,3400,3671 

Medical  Department ••-.■;:.-;.•.• .._-. /seOT  3655  3661 

naval  hospital  fluid .■■■:■;::.....  on 

outstanding,  amoimt  to  be  designated ......'. 

preventing  epidemics ■.■■.'."■''- "94 

public  works,  estimates  for .■-..■-  - . ....  - .-  -  -  -  -  ■ „ 

f.,,      ,  ■■.'.■.■.■.■.:. /1-75 

titles  of ■ ;; • ; _2  3433 

transportation  of  remanis ■......-. .^. .  j._.  -  ;^.  j. >    ; 

Armed  escort  for  ambulance  party -  •  ■  - ■  -  - - ' 

Arm,  flrst-aid  care  of  wounds  of -  • 

Arming  of  ambulance  party ■ "  ^ 

Armor,  battle  dressing  stations  to  be  behind.... 

Arms,  use  of  by  sanitary  formations 1  -qi  ir'>2 

Anay  and  Navy  Hospital,  Hot  Springs,  .\rk .:;::.■;:;; ." : : uyi-i'^- 

qideii 


m 


INDEX. 


^rmy:  Paragraph. 

Nurse  Corps,  service  in 722 

personnel  in  naval  hospital 30ii 

service,  not  counted  as  reenlLstment 205 

transport,  health  records  on 2290 

Artificial  limbs 1395 

"Ashuelot,"  pensions  for  widows  of  those  lost  in 3744 

Asphaltum ^. .'. 2097 

Assignment: 

Dental  Corps ,. 336 

nurses 671-677 

Assistant: 

chief,  Bureau  Medicine  and  Surgery 8 

civil  engineer- 
age  of  candidate  for 1965 

physical  examination  for 1931 

dental  surgeon — 

age  of  candidate  for 1965 

promotion  to ^ 320 

paymaster — 

age  of  candidate  for 1965 

appointment  of 1903 

physical  examination  for 1927 

physical  qualifications  for 1926 

surgeon — 

age  of 113, 1965 

appointment  of 1 U,  110, 1903 

candidate  for 124 

examination  of 113 

Medical  Reserve  Corps,  appointment  in  Medical  Corps 116 

physical  examination  for 1928 

professional  examination  for  promotion 191-193 

rank  of 101 

Asylum,  Naval,  government  of 1206 

Asymmetry  noted  on  health  records 2241 

Athletlc-s : 

goods,  entry  in  bill  book 1395 

outfits  provided  for  hospitals 1327 

relation  to  line  of  duty »t..i, 2832 

sports ,  traumatism  due  to ,,^ 2335 

Attendance: 
medical — 

officers'  families -^V-V-- i 913, 914 

ships  in  reserve 906 

Attendants: 

hospital  messes 1318 

patients  drtailed  as :/:.',...'.:.:./. .'.^f^^^^f^f^.^^ 1313 

Attention— 

to  patients  by  dental  officer 1024 

to  sick  by  Ilfjspital  Corps 845 

Auction  rjfeffccts  of  deceased .j^j...^.'^,, 2415 

Auditor  lor  Navy  Department,  contracts  nie<l  with ■..< 3313 

Auditory  defects,  degree  of,  to  l>e  stated 20(14 

Authority: 

Bureau  Medicine  and  Surgery — 

to  Issue  drill  regiilatiorei  for  Hospital  Corps 14,438 

to  iss\io  Manual  for  Metiical  Department .,......, 13 

civil,  deat h  reports  for 4002 

commissary  ofl'icer,  hospital  ship 612, 1022 


INDEX,  309 

Authority— Continued.  Paragraph. 

e.\ecutive  surgeon 1302-1313 

master  of  hospital  ship 17X0 

medical  officer gH 

nurses  on  duty gl7  1441 

obedience  to,  required 1729 

Autopsy: 

entered  in  journal 2318  2443 

performance  of 2443 

Auxiliary-les: 

naval  force,  pensions  for 3727 

naval,  hospital  ship  classed  as 1700 

officer  of,  absent 3012 

service.    (Sec  "Service,  naval  auxiliary.") 

venereal  disease 3013 

Average  complement,  method  of  computing 2379 

Aviation  duty,  physical  examination  for 2113  2302 

Bacteriological: 

examination  by  Naval  Medical  School 3221 

-       supplies — 

from  Naval  Medical  School 3228 

requisition  for 3.556 

Badge: 

.       Nurse  CJorps 771 

Naval  Reserve  Force 131 

Bag  room:  .    ..n>>i<bi^-^ui^-">ii>'j>i 

regulations  for ....... . .vs. 1433 

supervision  by  master  at  arms ..'.^..i....  1431,1502 

Baggage: 

allowance  when  on  expeditionary  service 1847 

disinfection  of 2770 

Bakery,  Medical  Department  use  after  battle. 1828 

Band,  as  ambulance  party 1822 

Barracks: 

disciplinary,  physical  examination  prior  to  transfer  to 2115, 2947 

marine,  sanitary  condition  of 2594 

Base  hospital: 

aid  to  wounded  at 18C2 

location  of 18G9 

Base,  sanitary.  Red  Cross  services  at 4352 

Bath ,  patient  to  receive,  on  admission -. 1502 

Bathing:  ,, 

precautions  concerning :. . . ; 2605 

required  before  battle 1825 

Battalion: 

ambulance  party,  organization  of .'i............  ^  1845 

organization  of :--u.;,.wi  -v.xjts-i9uiiii  Jsii5o,iMa 

staff,  post  of,  in  parades,  etc '.- . . .-. . .-  -1854 

surgeon — 

duties  of 1844 

post  of,  in  parades,  etc ,,........,.,...,.„„,^...,,feiL: 1854 

Battle: 

:•      care  of  wounded  in , , . , . . ^.. .  1801 

,       chaplains,  duty  and  station  in .^.ta zo.  h\av,.iii.iiiMl96 

dressing  stations 182*,  1827 

executive  officer's  report  after ,  Jiti<;  t^P.^ .,;...    1809 

fireproof  clothing  for , ,...,..-... 1825 

flrst-aid  service  during -.-..    1822 

Medical  Department,  conduct  in 1801-18^ 


310  IXDEX. 

Battl«~ConMnu9fl.  Paragraph, 

medical  oUicer— 

auties  iu '<r-^.  1«01-1><16 

duty  to  wuunded l*<11 

station  during 1S24 

pay  division,  station  in .-.J  '.'!'.•;'.'. ..- .. .-: : 1812 

reports  from  oflicers  after —    1S15 

report  of  killed  and  wounded  aficr ...•.-..■.■.■...-.■.-. 1805 

iransportation  of  wounded  durin;; .■.-. . . .-. 1822 

uniform  for 1*25 

Bed-s: 

convalescent  patients  to  make  their  own ..•.•.•.■.•.•.'■..•.•. lo2l 

hospital,  assignment  to  patients ^ .-.-.  .•.•...•.■..•.-..■.•.■.•.■.•. :  .■; 1320 

jiatients  not  to  sit  on Al>7.'i'jP.-.'M'.. . .  - . ...  1 l.ilO 

jiatient's,  nurse  responsible  for  condition ^. .>•--.-.•.■... Ufil 

Bedding:  .,.ir.,o,^.  . 

aired  once  a  week 2543 

appropriation  for 1307 

for  berthing  space  for  wounded 1824 

roll,  olTicers  on  expeditionary  service 1847 

Bellevne  Hospital  nomenclature ...-.•.... ....    2323 

Beneflciary-ies:  .  .o!  .£..,iiia«i>»-j 

classification  of ^''.S'SflfsB 

gratuity  pay  to . .  .-"il  »ftl,2431,3451 

pensions  when  in  hospital .• - .^- ......:.' 3656 

Berthing  space  for  wounded  at  battle  dressing  station 1824 

Blchlorid  of  mercury,  disinfection  by 3753, 2761, 2762, 276,'i 

Bidders,  acceptable,  named  on  requisitions .-. 3378 

BUl-s:  '- 

hook ...-.-.•.¥>.' .0.3«. 93C,S08, 1258, 1319, 4131 

instructions  concerping 1381-14(M 

lire,  to  be  posted .•.'.';. '.  X'J. 1321 

Form  5 -...i.i.iC^fi'Ji'j 3922 

FormC 3922 

hospital,  supervised  by  executive  surgeon .'.'!r.:.;i.M,'.;Wy:.0. 1314 

of  health ..■.^■^■..^. S»i6 

for  Canal  Zone 2735 

instructions  relating  to 2711-2722. 2741-2744 

laws  relating  to v..... 2701-2708 

medical  ollicer  to  secure ..•......;.... 2720.2721 

obtained  from  consul ......;.. 2704 

of  lading- 
form  for 3997 

memorandum -  •. ■■■  3998 

schedule  of 399<> 

liublic.    (.SVr  Public  bills.) 

Blnlodld  of  mercury,  di.siufcolion  !>> 2753 

Binnacle  list ■<4s.  872. 4121 

Birth: 

dale  of — 

entered  in  he^ilth  record ^ ;  •  •  ^■■'-  • --*i 

slated  under  oath 2081 

niiirk,  cxten.sivo,  rejection  for 20(>8 

Births  at  yard  or  station  lo  be  recorded '''19 

Blank-s: 

rornis.    (See  Forms). 

ivqucstfor :<i"<'l.ii31 

n'<|niri'd  for  reports -JIO" 

Blanket*,  washing  of 2543 


INDEX.  311 

Blindness,  color:  Paragraph. 

pxaminalion  for 2075 

rejection  for „„._._._..,, 19G1, 1981,2079 

Blood: 

for  Wassennann  test,  coliection  of -• -■ 3222 

pressure,  abnormal,  rejection  for 2113 

smears  for  Naval  Medical  School _.^.....^..,..^......^.. 3224 

stains  from  Naval  Medical  School .„,...,.. ...... ;.......,,. ^.....,..-...,,„_....... 3228,3550 

Boaid-s: 

academic,  medical  officer  member  of .,.;..„i^.;.....,._.....;.,.;.,._._._..... 938 

examining—  ijurtf  ot  pJiwb 

composition  of -  - .  -  ^.  .^^.o^ , . , . . 122, 174 

convening  of t-iiHJ^,'«*,r  -  •  -  121, 171 

decision  to  be  final 1983 

meeting  places 133 

merit  roll  of  candidates 1944 

organization  of 175 

procedure 173 

inquest —      892 

entries  on 2814 

ordered  in  case  of  accidental  death 2419, 2814 

regulations  governing 2401-242t'. 

inspection  and  survey  for  ships .........„.,,.,,, .'  —     891 

labor,  duties  of ?141-2154 

medical- 
examiners 893 

survey 894 

not  in  line  of  duty  entry,  procedure 2255 

physical  examination,  health  records , .  2213, 2214, 2251, 2266 

survey—  .      

composition  of ^  :5icnjs^  ,.,jf.j.j„.,. 2902 

entry  in  jouinal 1302 

joint,  for  pensions 2910 

on  material 907 

required  for  sick  leave —  -.-jTEJf  n- -rtr.r  r~ "  •■:  -•  - f,  - ^2909 

to  examine  transports  for  sick — .. ._. ,^1,..'......-^ ,...,,  .  900 

visitors,  St.  Elizabeths  Hospital  for  Insane - . . . . .  „,^.^.^,..,|^; 3104-3106 

Boarding  of  vessels  subject  to  quarantine ^s - ^717 

Boat-s: 

carry  hospital  flag 1853 

drill  in,  duties  of  surgeon's  division - 986 

hospital  detachment,  landing  force - 1853 

hospital,  equipment  of 987 

instruction  in  use  of ,..,,.,.,,,•..... 1722 

neutrality  of,  when  carrying  wounded ..,. r.;  —  -  ■■  -  ■•,< -  - 4216 

trips  dependent  on  sanitary  conditions 2541 

Boiling,  disinfection  by 2751,2767,2771 

Bones:  broken.  Care  of ^.^,,, 1008 

Book-s: 

ambulance 4131 

entries  by  officer  of  the  day 1363 

appropriations  charged  against 1397 

bill.    (S«e" bill  book.") 

bureau,  custody  of .'..4.4*.^ ^.j^^jj.^^^..,. 2 

disinfection  of .J';j..^;/.J.;....JJJJ.J„i.:„../^.^.^,....^.........    2769 

estimates,  classification  in . . . . .  r^^i^,  j.^^^,^. 23 

liandy.    (See  "Handy  Book.")  ;u  ,,i'i.-r-i((!,f:r-'>  ,tn:r:i'-t    ,  '<     /. 

Hospital  Corps  drill,  authority  to  issue ..,,,..yip, ...,.,*,,,, .1^438 

kept  by  ward  nurse , .  ,i....ir.  f^,.  ...^j .,...,.... , ... .  ^^    146S 


312  INDEX. 

Book-s— Continued.  Paragrat*. 

liberty,  care  of 1311 

op^ratinK  room 1350 

order,  kept  by  ward  officer , 1342 

pass,  supplied  by  Bureau  of  Medicine  and  Surgery 1311 

prescription....'. 963,1255,3525 

property,  kept  by  ward  officer 1342, 1346 

request  for 3991, 4131 

Brassards: 

description  of :..;:. 4251 

neutral  indi%'iduals  to  wear 42f>8 

stretchermen  to  wear -' 1^46 

Breach  of  discipline 871 

Breakage : 

reported  by  property  nurse 1^^ 

responsibility  for - 1^^ 

Brigade;  ....,-,.-,.,....     

commander,  brigade  surgeon  on  staff  of. ;  -.  .'.•.•.'.•.-.•.•j-.-..v.r.-.-.-.-.-.-. .-..-.  .•.•.•.-.-.•.•.•.-.-. 1S42 

dressing  station,  location •.•.•.-.i-.-iV.-.vA-.v.-.-.v.-.-.-.y.-.-.v.- .-.•.-.-.•.•.•. 1865 

hospital —  .......  .-.^ •--  ■■- 

aid  to  wounded  at . . . .-. •. :  1  ..."■. ....;...... 1S62, 1868 

designation  of .  -  - -  -  -•-' ^^^*^ 

naval,  organization  of . .  - 1841 

surgeon- 
duties  of 1^*2 

fleet  surgeon  detailed  as •  - H^l 

Bridge  work,  not  duty  of  dental  officer —  — 1033 

Brig-s: 

patient  confined  in l'**^ 

report  of ^^^ 

•     supervision  by  master  at  arms ■ H31 

visited  by  officer  of  day -  -  •■•  •• 1^'»8 

Bringing  home  remains,  charges  against  appropriation  for ..-.•.•.•..•.■.•.':'.' . . .  3400,3439-3443,3455 

Brooms: 

dressing  station  to  have -  - 1^24 

expenditures  for l^f*2 

Buckets  for  dressing  stations 1824 

Buildings,  hospital: 

authorized  by  Congress 1209 

'      no  change  to  be  made  in '"■»,  12S3 

vouchers  for ' ''^' 

weekly  inspection  of 12s^ 

Bulletin  board,  notices  on 1329 

Bulletin,  naval  medical,  contributions  to 2»i(>2 

Bulletin,  sanitary,  issued  by  fleet  surgeon ^  If'S 

Bumboats,  inspection  of ^•''3. 2571 

Bunions: 

entered  on  rejection  report 208! 

rejection  for •--••  1'*1>20T9 

Burean-s: 

V)ooks,  custody  of .;.\.\.w\:' 2 

chiefs  of—  

appointment ^ 

excmj)l  Ion  from  sea  duty ■  ■ ■'' 

rank  and  tit  le ^^ 

rank  when  retired ^ 

Navy  Department,  establishment  of 1 

records,  custody  of '"••■-  2 

Bureau  of  Construction  and  Repair,  equipment  supplied  by .• **21 


INDEX.  313 

Bureau  of  Medicine  and  Surgery :  Paragraph. 

administration  of  tiospital  ships  controlled  by • 1701 

appropnations '  ^  '  "^ 

assistant  to  chief  of ^ 

authority  of,  to  issue  Manual  for  the  Medical  Department 13 

authority  of,  to  issue  drill  book,  Hospital  Corps 14,438 

change  of  diagnosis  authorized  by 2353 

chiefs  of,  appointment _ '^ 

decision  of  line  of  duty  by 2813,3757 

design  of  hospital  ships  approved  by 1701 

Carididate-s: 
admission — 

age  of 1965,1974 

statement  imder  oath 1^^^ 

expenses ■ ^^^'  ^^'  ^^^'  ^^ 

gun-pointer,  examination 9' ^ 

merit  roll  of ^^^ 

nonappearance ^^ 

promotions,  statement  under  oath 1958 

Candy,  not  to  be  taken  into  wards 1515 

Caps,  disinfection  of 2769 

Carbolic  acid: 

crude,  as  insecticide ■ 2781 

disinfection  by - -. 2753,2765 

Carbon  dioxid,  destruction  of  insects  by 2781 

Cards:  

Form  F  (rough) ''■■■'-■'-'-• 3922,3936 

Form  X  (rough) 3922,3951 

outline  figure,  preparation  of 2101-2105 

permission  to  play 1509 

property  accountability •^070 

property  kept  by  ward  nurse 1^67 

Care  of: 

acids 903 

inflammable  stores 903 

insane  patients 1316 

patients—  . 

dental  officer aMi-aiab&.ia.l:. 1024 

executive  surgeon 1306 

property,  dental  ofTicer 1027 

sick,  responsibility  for 1281 

wounded -  ■  - 985 

Carpenter,  hospital,  report  to  executive  surgeon 1542 

Case-s,  surgical,  supervision  of 1350 

Casualty-ies : 

in  action,  key  letter  for 2355 

reportof ' 1816,3941 

rate  in  warfare 1^22 

Catarrh,  chronic  nasal,  rejection  for - 1961, 1981,2079 

Causes  of  injury,  classification  of 2335 

Cavities  of  teeth,  classification  of. •os'.iiriiu.w*:'.uj.'. 2271 

CeUs: 

inspection  of ^54, 2572 

report  on  condition  of 2653 

Cemetery-ies: 

hospital,  to  be  kept  in  good  order 1324 

naval,  headstones  for  unmarked  graves 1292, 4131 

record,  supervision  of 1319 

Cerebrospinal  meningitis,  quarantine  for 2733 


314  INDEX. 

Paragraplir 

Ceremonies,  swords  to  lie  worn  at 'j'Ji'fiii'iL^Q ...  - J***5 

Csrtlflcato-s:  ■ 

admission  to  hospital  (foreign) -,w...-.......< 905 

death :.;... I..;... ...*..;.. 825,1141,2815 

lor  civil  authorities '•^'- ••>>-<'^ 4002 

FormN .:.:.;v:-.  3M4,4121 

discharge  from  hospital  (foreign) ^05 

false,  penalty  for 126 

identity,  armed  escort  of  ambulance  party 1845 

medical- 
civil  employees 2131,21o2 

court-martial  proceedings ^^ 

St.  Elizabeth's  Hospital  for  insane 4^1 

member  of  general  court-martial 89( 

of  examining  surgeon  on  service  record 2081 

t      pensions — 

descriptive  list  on ^"^1 

medical  officer  to  give ^^^ 

r      required,  candidates  N.  R.  F 1^2 

unofficial,  prohibited ^1 

Change: 

diagnosis- 
abbreviation  for "M 

authorized  by  bureau 2^^ 

l^rocedure ^^^ 

Hospital  Corps,  report  of 3953, 4121, 4131 

of  Stat  ion,  nurses f'^*^ 

rating  in  Hospital  Corps,  report  of **7 

Chaplain-s: 

ape  of  candidates  for 1^' 

appointment  of 1^^ 

duty  and  station  in  battle 1*^ 

neutrality  of 4203,4240 

physical  examination  of 1^^ 

services  of,  at  funerals ^■*** 

at  hospitals ^^^ 

visual  acuity  required  for  admission ^^^ 

Chart: 

climcal,  Form  Q 3922.3947,4121,4131 

Checkage  for  naval  h-^pital  fund . .' .' 731 ,  1202, 1268, 3602, 3606,  ,3621 ,  3624, 3625, 3651 

Chemical  examination  by  Naval  Medical  School - 3223 

Chest: 

<iiseases  of,  rejection  for 2079 

expansion,  requirements  for  midshipmen 2084 

measurements,  entered  on  liealth  record 2241 

tables  of 2082.2084 

variations  from  standard  of 1962,2083 

Chief  engineer:  

hospital,  report  to  executive  surgeon —^ '•'*^2 

hospital  ship- 
duties  of 1  •■'^'  1'*^ 

Chief  nuise-s: 

appointment  of C61-66.-> 

conference  of  nurs«w i. 4^, . -•  .J . .>^ i •i'.-i-iU    1443 

conference  with  executive  siu-geon • ;.....-  —  —  •'  144.3 

daybook  kept  by ^*^'' 

duties  in  hospitals I4»l-l47n 


INDEX.  315 

Chief  Nurse-s-Continued.  Paragraph.^ 

efficiency  reports  prepared  by '^-^ 

inspection  of  hospitals ■ 1443 

instruction  of  Hospital  Corps - - ••  - •  •  1447 

>.     instructions  transmitted  through 1444, 1457 

i     keeps  health  records  of  nurses ■■ '1^ 

leave  of  absence 1448 

nurses  assigned  by -  - ...-..•.. 144.3 

nurses  supervised  by - • ^440 

orders  presented  to  pay  officer - •  -  •  .•.•.•;:--'.:•.:■'. i2i 

pay ■  ■  -  ■■ •  ■  •  ■"-■-'•■'-"■"-■ '-^ 

records  kept  by -■ •■ ■-• ^'^^ 

register  of  nurses  kept  by -  - ;  -  —  ••  -■  -  - 1"*^^ 

•     reports  forwarded  through 1443 

sickness  of  nurses  reported  1>y -, 1"*^ 

supervision  of  nursing  by ..^;V 1443 

temporary .-.-.■.-.-.''Pl^. ': 1448 

Chief  of  Bureau  of  Medicine  and  Surgery: 

appointment  of •  — '^ 

assistant  to •  •' ^ 

Chief  of  Staff,  papers  referred  to  fleet  surgeon  by ...■.-.-..■...-■ 1139 

Chief  pharmacist:  ' 

classification  of ^"H 

duties • 443-445 

precedence ^  '*" 

promotion  from  pharmacist ^"'j  ^1 

rank  of ^^^ 

Chief  Pharmacist's  Mate:  •  ■  -— ■ 

enlistment  of ...-...-.-.-.■.-.•.-.-.-.%-. 451 

(See  Pharmacist's  Mate.) 

Chiefs  of  bureaus: 


appointment  of. 


exemption  from  sea  duty ^ 

rank  and  title " 

retired,  rank  of ' 

Chinaware,  appropriation  for l'^^' 

Chlorinated  lime,  disinfection  by -'^ 

Cholera: 

precautions  against 2603,2615 

quarantine  for ^^ 

Chorea,  rejection  for ■   ■  •  • 20<^9 

Chromatic  sense,  determination  of -^'^ 

Circulars: 

relating  to  enlistment - - 2041,2042 


relating  to  Hospital  Corps. . . 
relating  to  venereal  diseases . 


of  warning 


411-413 
2252 

2252 


Citizenship  required  of  all  officers - 112, 131 

Citizens,  officers  of  vessels  to  be 1901 

Civil  authorities,  death  certificates  for '**^-^ 

Civil  employees  {See  Employees): 

admission  to  uaval  hospital 

to  hospital,  under  compensation  act 

affidavits  upon  death  or  injury 

application  for  leave 

■compensation  to  dependents  on  death 

disabilities  to  be  recorded ^^'^ 

extension  of  leave  for  illness — . .  - -  - -  -  -  -  -  -  -  -  —  -  ■ ^129 

height  and  weight,  tables  of 


2174 

: 1543 

..:').ii'}if.:''li'^iP?^... 2164 

'^y[y^^ 3995 

.25iJuJ>K';  2162 


2152 


supervision  of,  at  hospitals . 
transportation  of  remains. 


316  INDEX. 

CivU  Employees  {See  Employees)— Continued  Paxajn»ph. 

injured — 

ambulance  servMce  for ^'^^' ^^  ''^ 

medical  officer  to  examme "" ' 

21 09 
injury  to  eyes 

leave J,^ 

for  contapious  disease  in  family - 2130 

for  sickness "^"'^ 

medical  certificate ^'^^ 

examination "^  ™ 

,  34(»0 

pay  of 

roll  of ;-.f2 

under  compensation  act •^^**'  -'*^* 

physical  examination 2121-21 70 

preference  for — 

disability  in  line  of  duty 2132 

honorable  discharge 2132, 21.50 

report  of— 

death  from  injury 21t>3, 21 ,5 

injury  to ■ 2171,2175 

subsistence  in  naval  hospital 12,6,.W4,3f.57 

1542 

34c;o 

treatment  in  naval  hospital • .--.-.-.-.-.-.-.•.....-.-.....-•  1241, 1276 

Civil  engineers,  visual  acuity  required  for  admission -.- - •  • 19f'3 

Civil  hospital-s: 

care  of  patients 

expenses  of  patients ^^ 

health  records  of  patients 

medical  history  of  patients - ^24 

report  of  patients "  ■  -• *^ 

transfer  to • 

CiTilian-s: 

crew,  hospital  ship — 

classification  of ^_ 

regulations  for ^ '  2* 

examiners,  Form  X  (rough)  prepared  by ■ 2051 

medical  aid  to /^ 

treatment  in  naval  hospital •'"' ^ 

Civil  Service  Commission: 

Form  No.  1042 *'"** 

Form  No.  IHOO ;»i*-fn»H*«i' 2152 

Classiflcatlon-s:  

disea.sps "  ' 

Hospital  Corps •••-' L:,„ 

.   .  '.  2360 

injuries 

international,  of  diseases  and  injuries ■^"•^ 

.    „,  23411 

poisons ^^ 

Class  number,  Navy  classification  of  diseases 2368 

Cleaning: 

detail,  master  at  arms  to  make - -^ '^^ 

gear,  oxitcnditurcs  for - 

Cleanliness: 

hospital,  responsibility  lor.. 12hl,  1343, 1347 

,  .  2542 

«''"' ::"■":;: yss 


S24 
824 
M4 


Clear  ship  for  action,  inodical  ofHcer's  duties 

.«4V 

1372 


Clerical  work,  hospital: 

duty  of  pharmacist "^^ * 


system  of r> •  *•''• 


imyEx.  317 

Clerks,  paymastei's.    (S«e  Paymaster's  clerks.)  Paragraph. 

Climate,  clothing  adapted  to i'.;' Jfi W.".".*!?.! i?f-.-i 2605 

Clinical:  - 

chart,  FormQ .......\..»-.-..i.i;..;:: 3922,3947,4121,41,31 

notes — 

form  for <  ^  <  .  :  s  :  s  :  :  =  :  m 3969 

made  by  nurse ........-.•.■..;.; 1407 

Clothing : 

adapted  to  climate  and  weather ■. 2605, 2010 

allowance  for  Hospital  Corps 1847 

when  serviag  with  Marines 1847 

allowance  for  Naval  Reserve  Force 131 

destruction. of,  to  prevent  spread  of  disease 2536, 2956 

disinfection  of 1310,2753,2768,2770 

division  ofTicers  inspect 2543 

dried  before  stowing 2543 

fireproof  for  battle 1825 

for  landing  parties 2621 

furnished  to  insane -. 3155 

Hospital  Corps,  inspection  of i 1326 

Ibt— 

disposal  of 1365 

verification  of 1502 

patient  in  brig,  care  of 1486 

report  on 2653 

roll,  officers  on  expeditionary  service 1847 

washing  of,  in  wards 1518 

Coal,  entry  in  bill  book 1394 

Coaling  ship,  preparations  for  emergencies 981 

Coast  Guard: 

admitted  to  Army  and  Navy  Hospital,  Hot  Springs 1611 

cooperate  with  Navy ' 3723 

pensions  to  officers  and  men  of 3724 

Cocain  habit,  evidences  of 2063 

Cockroaches,  destruction  of 2781 

Cold,  esposure  to,  to  be  avoided 2621 

Collision  drill,  surgeon's  division  duties 982 

Colon,  quarantine  jurisdiction  at 2735 

Color  blindness,  rejection  of  candidates  for 1961, 19S1, 2084 

Color  perception: 

determination  of 2075 

standard  for 1963 

ColuHm,  transport,  organization  of ^ 1842 

Comfort:  .-.i^'X  '.'.  j 

crew,  fires  for - 25-38 

lights  for .....::. 2539 

troops  embarked 896 

Commander  in  chief : 

hospital  ship  iaspected  by 1709, 2512 

material  surveys  ordered  by 2969 

naval  hospitals  inspected  by .■ 1251, 2512 

reports  of  contagious  or  infectious  disease 2513 

returnable  through 1141-1154 

submitted  to,  by  fleet  surgeon .-.-.•MVA'^l 1140 

returns,  ship  separated  from •..•.■.•-•. 1154 

sanitary  duties  of • . .  -  ..•.'.;. 2511-2525 

stafl  of -  - ". -  -  -  1111 

suggestions  from  fleet  surgeon 113^ 


-318  INDEX. 

Commanding  officer:  ^xn.  I'aragraph. 

complies  witli  quarantine  regulations 2711 

healtli  records  inspected  by 2224 

hospital  ship ~  i 1"10 

authority  of .:..  611, 1022 

responsibility  of 1223 

inspects  medical  joui-nal -  ■  -  •    2312 

opinion  as  to  line  of  duty i  i . .    8442 

recommendations  to ■  - 2563 

sanitary  duties  of 2531-2546 

signs  descriptive  list  on  report  of  death 241*< 

pension  certificate 3751 

10  consult  medical  olBcer '^2 

,  Command,  succession  to,  on  hospital  ship 1710 

Commissary : 

hospital  steward  in  charge  of ..,,....., 1348 

'        pharmacist  in  charge  of -......„...«»»..», ^ 1348, 137),  1373, 1411-1415 

, Commissary  ledger: 

forwarded  to  bureau 4 131 

instructions  relating  to 1411-1418 

ration  memoranda  for 3965 

receipt  and  expenditure  voucher  for 3966 

supervision  of 1319 

Commission.    (Sft  Going  into  commission.)  .  lo 

Commission,  Civil  Service:  

Form  No.  1642 -- .-■  ^'144 

Form  No.  1800 2152 

Commissioned  officer,  health  record  lor 2243 

Commissioner  of  Pensions,  laws  administered  by 2822 

Communications : 

Nurse  Corps,  via  official  channels. ..,-^i(.H^. 708 

restriction  of ................,..,,.,,,,,.,.., 2518 

Commatatlon :  

quarters,  Nurse  Ck)rps — ......... . . ........... ..^.. dl8, 753 

ralioas, Nui^e Corps ^t..^.,..^ 741,742 

Company,  organization  of .t,.  juj/j;  <ui.  ii..  j.. 1841 

Compensation: 

act,  instructions  relating  to :<!171-2176 

payments  luider 2166,2168 

physical  examination  under 2121-2176 

dependents,  on  death  of  employee.. -.•.--.-•- -,•.•■  .--...■.■■.•  — ,  — .-. 2162 

injury,  authorization  of ..._._._............................,..........,.... ^^.^^^^^^ 2124, 2161 

to  employees ...•■. .....................-.....; .... . ; i; . . :-. r; . .-.-.. 921,931 

Complaint,  nurre  to  commanding  officer 1451 

Complement:  ;w.... 

average,  method  of  computing ..............,,.,..---.-..,.-  ■••••. 2379 

civilian,  of  hospital  sWp — ■ 

cla-ssiflcation  of -, 1716 

regulations  for •.•••.••  1728 

Conduct: 

improper,  forbidden •.•..••.•.. •.•.-.•.•.-.■•.••.•••.•.• ^^"^^ 

record  super\'ised  by  officer  of  day ..a.m«j.(,.. <-^ 1363 

Confinement:  

entered  in  hospital  join  nal .._....._..............., .  1>W2 

palinnl,  in  brig ^ 1-W6 

si)accs,  report  of .-.-.•  -.•.•.•.•.•.•.•,•.•.•.•.•.•.•.•  .•.••.>-.»»..«*.. ''^ 

Conflagration,  injury  by 23;i5 


INDEX.  '^i9 

Paragraph. 

Congress:  „i  ,,^„uai  f„nri  .j,-w,a>„v>...  3607,3655,3601 

appropriations  for  uaval  hospital iund j.*r.rvw>*,  >       » 

estimates  submitted  to • 

hospital  buildings  authorized  by ^^ 

sites  authorized  by - 

physical  examination  requested  by  Member  of ... ; 

Consent  for  enlistment  of  minor ""  igsa'wsi  "079 

Constitutional  weakness,  rejection  for .-.--.•.•.•.■-■.-.•.-.-  .-kp-  •         '        '  - 


Construction  of  hospitals:  -r- rrrr- •  v   : 

2621 


recommendations  for • ,.,,^, 

_  -  i.jyo 

vouchers,  filed • • 


2704 


Consul: 

bills  of  health  obtained  from - ^^ 

health  records  transferred  to •-■k4  f,-o>-Hf  -Mi i>^t3U^ If  -  - -» 

Consultation:  —  ■  • '  .,    .  .,^., 

commanding olficer  with  medical  officer ,..........,,,......-.. i-,.—.*v.i. -     ,- 

fleet  surgeon  with  medical  officer r  r r  -  -  v. ,  h- 

regardinghealthofcrew ;:':::::::"8*V888;  1342.1350 

regardmg  treatment ^^-^ ,......--r .  ■  ^^^^ 

Contagious  camps,  instractions  in  hygiene ■ -.  t  t  :  -  t  -.-.:-.-  -. 

Contagious  disease-s: 

abUity  to  cope  with • ,.:....  t^nth^^* s«i 

care  of " " ■-•.-.-•- 

detail  of  patient  with ^ 

disinfection  of  clothing. • ..,,,. -..-....--i.:--,-.H.-rt'iJ-;-.-- ^ 

disinfection  of  ship ......,.....,..---.-,  --^■f^'r.'-.L. -••-•-    - 

in  family,  employees  leave  because  of ,. .-.fT^.v . . :  ..i . _ 

in  West  Indian  ports,  report  of ■■■■■ ............4'.;fo.^M'>;.r-»iV>i^V"   ^7 

medical  officer  notified  of ..v^^.. ........... ...   -^^ 

men  with  not  to  be  transferred • "" 

patients  not  to  beinlandmgforce ..-.-. ;;;:;:  :-yi,:;2no7;2608;26i+-2617 

precautions  regardmg '  oio 

prevention  of .-.--,- wrsm  « 

rejectionfor 4ftkkKrfi^m.^>|i<.^^«^^ s^o '828  4002 

report  of .._.         .^fvKwxx.. '    S'S 

by  commander  in  chief <Hu.ba«so?<i-a^9Jfc% -jaid.^&oi 

treatment  of • ■  -  -  - -.-.-.-l^ai.taofi  4, -.,- 81^ 

Contingent:  ■'<■■■  -"  „  , . , 

Marine  Coi^s,  charges  against .„,.-.....-....-.......-.-.-.-.-.-.-..-.-.-.-.-.•.■.-.-  •-■  --.-n^d., *M4, aoi^ 

Medicine  and  surgery— djecfi  sni-':;'.    Mii;-; 

entry  in  bill  book .-• --•• ..a«)Js*iai»i«.  - -: 

Continuous  service :  

certificate,  number  entered  in  health  record -. --  •  ---.-.-  ■.^-  --  ■  •  ■■■.■.■ •  -  -    ^_^ 

man,  physical  disqualifications  for  rcenlistment -  -  -  •  -  -  .ait = fi^-w-iici  iuiU-^ 2010, 2004 

NurseCorps ...,..,,.,, 

Contract-s:  „.,_. 

^    ,    , 3o0u 

control  of ^.-...--- .-.-.-.- ^  .3312 

filed m  returns  office ..-...,.,„.,-. -.^=-,,.;«-'«. ■.•'.«.'...'.---■'•■: 

for  supplies  or  services,  how  made. -  -  -.-.-  -  -.-.-.-.--.-  .-k*  ^^'.ut^^-^ai .?-?  *rfK.£*5i7W378 

letter  of  instructions  concerning - .,.....,.....,, ^ 

oath  required ^ 

original  filed  with  auditor ..>,,;►....-£.. ,„.,. .^..., ......,, -...«^^ 

penalty  for  omitting  rctimis  of -.->x-»v.  U.t*»*  Ja-v.,'*  J-  .i.vri,ri.-sov.  «v«itt 

status  of  United  States  when  making - .-.-■,  si.iv fv>ii-.j>.?vt..v.:-.;i».-.4ooJ.'.*-  -  »«» 

supplies  furnished  by ;.-;.5:.-.T<.!-i-'ii>-.--i-r»'?'----    ^ 

to  be  in  writing. ........ -"..•-•• '■--•- ,......,..>.^a>>41"..< 


320  INDEX. 

Paragreph. 

Contract  nnrse ,  service  as i^iit UW'il'A;  ..»..„,.. 722 

Contractures,  entered  on  rejection  report imii,ii:ii.i.ii..nffiti 2085 

Convalescent-s:  ••'••     ^'  ^  ' 

camp,  base  hospital  acts  as i... -  -  • • 1869 

detail  lor  work ; 1313, 1507 

discharged  when  fit  for  duty 1230 

make  own  beds 1521 

returned  to  duty  promptly 12fiC,  1286, 2948 

Conventlon-s  (See  "Geneva  Convention"  and  "Hague  Peace  Conference"): 

governing  hospital  ships 1704 

Convoys  of  evacuation -  -• 4248 

Convulsions,  rejection  of  candidate  for 19C1, 1981,3079 

Cooking: 

examination  of  water  to  l)e  used  for i 25C9 

instruction  in 1375 

utensils,  cleanliness  of 2544 

disinfection  of 2772 

Corns: 

entered  on  rejection  report 2081 

rejection  for j... 3079 

Correspondence : 

course,  Naval  Medical  School -  -  - 3320 

fleet  surgeon 1131 

hospital- 
duty  of  pharmacist -. 1371, 1372, 1389 

hov/  conducted 1262 

Nurse  Corps— 

via  official  channels 708 

Cost  of  maintenance : 

from  hill  book .•..v..w.- 1384 

statement  of 1421-1425,1431 

Court-martial:  ' 

fines,  for  naval  hospital  fund ^„,,^. ,.^,,,— , 3ti03, 3658 

general.    (Sfc  General  court-martial.)  

indorsement  on  record  of 829 

medical  certificate  on  proceedings  of 895 

summary,  at  naval  hospital 1277 

Court  of  Inquiry: 

entries  on 2S14 

on  accidents  causing  death 2426, 2814 

Crew: 

consultation  concerning  health  of 254.5 

examination  of,  going  into  commission 842 

exposure  of,  to  be  avoided 2543 

fires  for  comfort  of ....  ,....vi..»i....j 2538 

health  of, consultation  regarding .1. i :'.j ..•..'. . ^ . . 4';.'.. ; 802 

lights  for  comfort  of 2539 

merchant,  hospital  ship  manned  by 17U5 

physical  capacity  of 254t> 

preservation  of  health  of 2533 

provisions  for,  insi)CCtion  of ''*^>  2568 

sanitary  condition  of "•"' 

vaooination  when  going  into  commission 25. (> 

Criminal  applicants  for  enlistment,  detection  of 2063 

Crown  work,  not  duty  of  dontnl  officer 1*133 

Cruise,  medical  officer  detached  during • • • 831 

Cruising  ships,  ro(|ulsltions  from •  •  -  859 

Cmsblng,  traumatism  by ■* 2335 


INDEX.  321 

-,  ..           ,         .  Paragraph. 

Culmary  department,  entry  in  bill  book , J397 

Curtains,  disinfection  of 27rg 

Day: 

book,  chief  nurse  to  keep ,  j.r 

off  duty  in  hospital , oro 

officer  of.    (See  Officer  of  the  day.) 

Dead  (.See  Deceased;  Kemains): 

burial  of,  appropriation  for 3^0^  ^,^ 

disposition  of 183l'34C"> 

identification  of .'.'.'.'.'.".'.'."'."'.'.'.".'.".'.'.'.'.'"l826, 4235' 2097 

transportation  of,  appropriation  for -2  3433 

Deafness:  ' 

examination  for „.-,,, 

Mib 

rejection  for ■>• 2070 

Dealings  with  patients,  prohibitions  regarding. 434  970  1269 

Deaths:  '      ' 

accidental — 

board  of  inquest  ordered ,.ai., 2419  2814 

court  of  inquu-y " '  2425'  2814 

at  sea,  funeral  expenses '  04.50 

certificate^ 

entry  as  to  line  of  duty 2315 

for  civil  authorities 40^2 

entered  in  journal '"    ™,o 

ship's  log 2412 

from  injury,  report  of '2163  2175 

violence,  procedure '  242'> 

in  civil  hospital „.„^ 

in  foreign  country,  funeral  expenses 345&-3460 

in  St.  Elizabeths  Hospital  for  Insane 2438  3i3f 

in  Hawaii,  funeral  expenses ' 344, 

in  Hospital  Corps,  report  of 4a., 

in  line  of  duty ^  "  ^  ^ 2846 

in  Naval  Hospital .ga- 
in State  hospitals  of  California,  for  insane 2439  3157  3162 

medical  officer's  opinion  as  to  cause  of _  _  '        '2422 

noted  in  ship's  log „.„, 

of  employee,  affidavit  upon 2i64 

of  employee,  compensation  to  dependents 2162 

of  officer  in  charge  of  stores 2953 

of  retired  officers  and  men 2437 

^^l?°^io^ ^'."'.'.'.'.[\\\'.'.'.'.'.'s25^nil,3912 

evidence  for  claim  for  pension 2si7  3"5S 

^°^™^ 3922, 3941;  412l|  4131 

preparation  of 2401-2443 

to  department 241'} 

to  next  of  kin -^ .'.'.'.'.'.'. '^  m5^2413,Z45S 

while  on — 

leave  of  absence „,„. 

,.,      ,  2435 

^'^^-^y-; 2846 

special  duty 2435 

waiting  orders 243- 

Deceased  (see  Dead): 

accounts  of 24or 

discretion  as  to  disposal  of  effects 2417 

disposal  of  papers  of '    241/5 

effects  of— 

collected  and  inventoried 2414 

sold  at  auction 241'- 

98601°— 17 21 


322  INDEX. 

Paragraph. 

Deck  courts,  at  Naval  Hospitals -  - .  .i. - ..-—.. . . .  j:  ....  .•.:.. . . .'. 1277 

Deck  officer,  hospital  ship,  duties  of ■-•.•. .v.-.v. .•- . .-A*. i'il'J. -I'. '.'. 1739 

Deck,  11S6  of  harbor  water  on 902,2545,2603 

Defects,  curable 2081 

Defects,  physical,  waiver  for 940 

entry  of 2052, 2081 ,  2241 

request  for 2064 

Deformity : 

entry  of,  in  rejection  report 2081 

rejection  for 19«il,  1981^2079 

Dementia  paralytica:  '      '     .       ^'.-^^ 

method  of  entering ^59 

rejection  for - .  .^-•v.-.-.  ^.•. .-.-.  .•.•..-.-.-.•.-.■.•.•.-.•.•.•.•.-.  .•.•.■-•. .  2079 

Dengue,  precautions  against -  - .  - .-...-.....-.. 2615 

Dental  Corps: 

age  of  candidate  for 1965 

appointment  in :U1-313 

appointment  in,  subject  to  examination ■.■....■.-.•.•....■.■..-.•.■....;: 333 

examination  of  applicants  for. ...•.■.•.-.-..•.  .-.-..-.■. 313-318 

laws  relating  to ..................^-^^^m^mj. 301,302 

Navy  Regulations  and  Instructions  regarding 331-340 

phj-sical  examination  for •.■.•.-.•.-.■.-.•.•.-.•.-.-.•. 1923 

qualifications  for  appointment ......-.■.-.■.■.-.-.-.•.-.•.• 315,332 

rank  and  pay  of -.. •.. 305 

retirement - .....•.■..-.-.•..■.•....■.•.•.•.•.•..-.■.■.•. 307 

tenure  of  office  in ^  v. ^.■.  •-■.•..  v.  ■.•.-.-.■...•.•.•.  •..-.:.■.'.. .'.' 305,306 

uniform  of ....-.^^v.-....^-...-.-.-.. -..-.•.?.' 305,322 

visual  acuity  for  admission .■■■■■■  ■■■■■■  ■■■  ■■- -- . -  — 1963 

Dental  officer- s: 

assignment  of <-.-.-.. 33t> 

at  Naval  Academy .>■.•.-.■.%-.•.-.•.•..■.. .  .■.■..•.-.%. 301 

attention  to  patients ..,,<,...^(-;iii:-. .-. ^^ 337,1024 

bridge  work  not  duty  of -.^^  .>-.-.-.  .-.■.•.•.■- ..-. 10:53 

crown  work  not  duty  of ^..v.,.^.-... 1033 

dutiesof - :{3«,  1021-1038 

forms  part  of  surgeon's  division 331 

for  temporary  duty 323,341 

gold  work  not  duty  of 1033 

hospital  corpsman  for  duty  with 474,1038 

information  to  medical  olficer ,,^^v^-^.^-.-.^-.- 1025, 1034 

papers  required  for  examination .•-■ -..■.•.^-.-. ■..-.. —  312,313 

permit  for  examination v........ 312 

part  of  medical  department '.'... V.. I. . —  M23, 1031 

patients  admitted  to  sick  list - ..>.....-......•..  1034 

probation  period .— . ...•.•..•.-.-.•.  .■.■...-..•..  303 

property  accountability • - 1027 

prosthetic  procedures 1033 

records  of  work .  ■ .  1026, 1^5-1037 

requisitions ML's.  1037, 1039. 3'»31, 3932 

Reserve,  see  Naval  Reserve  Force. 

responsible  for  dental  property — '39, 1040. 1041 

services,  persons  entitled  to 1032 

statistical  report  of  work 1''37 

to  keep  records  of  treatments — 338 

towels  and  aprons  for ,,,«.s,^»,.-..v..v;-.,i. .  1042 

Dentaloperatlons,  report  of,  Form  K,  page  8  b.. 3922 


INDEX.  ;^!2;i 

Paragraph. 


Dental  record. 


103.V10.S7 


entered  in  health  record -  -  -  - 2267-22, 1 

for  insertion  in,  Form  H • —  - • "^^^2 

Dental  report  in  Form  K •-•-  - ...-..-.--'-- :  -'  :■==-  i'.-  .■.-; .:..-. 2388 

Dental  Reserve  Corps:  ' .- 

age  of  candidate  for _  1985^ 

appointment  in .•  •'  —  3ol-3oD 

authorization  of .........^r.==l«.¥PJV..: 303 

laws  relating  to ■.•.•..•.-.-.•-■.•. ...•.-.•.......-.-.-.-.■.-.-.-...■: 303 

physical  examination  for ..■.•.•.■.-.■,-.-.- .....-....-....-.-.-.-.-.- .-.-r. .- 1060 

imiform  for .'^l-.v. . ..•-.. .... -■- ..•.-.-.•—-.-.-.-.■..■.-.-.•.-.-.•.-.-.-.-.•■•---•- •--■  v . . .- .- .r . . .      358 

Dental  services,  reimbursement  for. ..-.-.-.-.-..-.■.-..-..-.-.•.■.•.-.•..-..•..■..-.-.•.-...■.-.•.•.-.-.-.-.-.--•.».- .r**, .-.-.■  .'tV/  '3342 

Dental  treatment:  — '^'"''^' 

abstract  of ^.^.,w^^^. ^^^^.^.^s..... 2270 

entered  on  health  record — .^.-..-;;;.-.-.-.i. -...-. 2207 

Department  of  Interior,  form  for  admission 3120,3130,4001 

Department  of  Labor,  blank  forms h'-A'iV. '.-.'. . 2172, 217.5 

Dependents,  compensation  to,  for  death. ...  .-..-.•.-.-.• - •  •    21G2 

Deportment  to  be  civil  and  decorous - .  -  -  ■ .  ..■..•...-.--  -  -  -■ 1"30 

Depot-s,  medical  supply.    (Sfc  Medical  supply  depot.) 

Deratlzation 2763, 2781 

Descriptive  list: 

2077 
entries  on •.;.-.-,•.-.-.-.■.■.■.-.-.•.•.■.:.•.■.•.■.•-■.■-•.•.■.•.-..•.•..--■. •^^" 

on  pension  certificate ■.......■....-.■.-.-..■.•-■.  ..■..•-•;•- .-.  ^  i  I'i  - - ■  •  -  ■  •  ■''•'l 

on  report  of  death - ....^..^^^ivM'ii0.ii^^yiii.^^  .iv .;; .  2418 

preparation  of - ..^.l«1M01-2105 

Deserter-s:  •■ 

abbreviation  for -.....^^-.*-.-. 22n4 

enlistment  of,  prohibited -  -  -  -  -■-  --■•--  •  •  - .........;;....  ..j. .. . .  -• ....  2001 

health  record  of ....:..... ..........  v............ ^ ...:•.■.•:  2291 

Desertion-s: 

disposition  of  forfeitures  for •- .  -■-  -  --.-.-  -  - . .-  --V^imQ  Jsoiti-i'. 1204 

forfeitures  credited  to  naval  hospital  fund. . . ................ .  ....^^.^.  .-.-.■. ...-.-.-- 3Wi9. 30.i7 

in  Hospital  Corps,  report  of - .^.L: .i'; 4S, 

noted  in  ship's  log ••-- 3'*32 

Design  of  hospital  ship  approved  by  Biueau  of  Medicine  and  Surgery..-,. ...-•.i;.'.. . .  .v. -1701 

Detached  service:  .-  'i..^. 

health  record  of  ollicer  on ■ ^^2 

quarters  for  nui'ses on .•.•.--..- ... . .■.■.•.■.-.•.•^^-^.-.--.•.- ■.~-^- '-^1 

Detachment:  

medical  ofQcer  during  cmise -  •  -  - ^^_^ 

entered  in  medical  journal ^-^'^2 

officer  notifies  medical  officer  of 2302 

Detail  of: 

hospital  apprentice  as  sick-bay  recorder ■I'S 

Hospital  Corps  on  hospital  ships ■_  "•2^ 

Hospital  Corps  with  dental  officer ^"*- 1^38 

medical  officer  of  tlie  day - ^-^^ 

nurses --■' • ^!^ 

officers  for  special  duties •  •  ^"^-'^ 

patients  for  work  in  hospitals 1-^13, 1507 

stretchermen,  to  be  permanent l^'^ 

Diagnosis: 
change  of — 

abbreviation  for ^^^ 

authorized  bv  bureau - '^^^ 

procedure ^-^ 


324  INDEX. 

Diagnosis— Continued.  Paragraph. 

method  of  dctenniuing 225S,  2329-2333 

secondary 2'253, 2259, 2329-2333 

sjTnptom  not  used  as 22-;S 

"undetermined "  use  of  as  diagnosis 2332, 23o4 

Died,  abbreviation  for 22S4 

Diet: 

kitchen —  

regulations  for --•.--.-.-.- 1581 

supervision  of Uia,  1450 

Ust,  special 1233,134^,3913,3961 

sheet 3971 

special '^'*»  ^^o,  13*4 

from  ward-room  mess 3422 

tables,  variations  in 1232 

Diphtheria,  quarantine  for 2733 

Disability-les: 

degree  of,  to  be  stated 3. 01 

discharge  for •■  1236,2^15 

due  to  own  misconduct 2254, 2818, 2s20 

entered  in  health  record 2208 

in  line  of  duty,  preference  because  of 2132 ; 

retirement  for 2^2  , 

not  in  line  of  duty,  procedure 2255 

of  medical  officer,  next  in  command  succeeds 830 

origin  of,  decisions  regiirding 2S21-2837 

physical — 

in  line  of  duty,  retirement  for 1912 

procedure  upon  fmding .-.-.--.-.-.--.-.-.- 1~3 

rank  when  retired  for .k  ..:..-■.  ^ lf>5 

recording  of .  ^ 2176 

report  of — 

in  absence  of  medical  officer 2215 

termination  of --'■■' 21  •  5 

sliglit,  entered  in  health  record 2250 

specific,  pension  rate  for » 3734, 3735 

total ,  rate  of  pension  for ^, . .  .ni^^^'^i^:  jiB.-ftnj -sb o730 

Disabled: 
men- 
half  rating  of 3706 

pensions  for 3711 

officers  and  men,  pensions  for  widows  of 3712 

traasfer  of,  instructions  regarding -^ 3O*n-3011 

Discharge-s: 

abbreviation  for rr r    22S4 

and  transfer  slip 3984 

Ix-forc  termination  of  enlistment 2031 

by  mediciil  survey,  truusportation  after ■    2!)07 

condition  noted  in  health  record 2260, 22S3 

convale.sccnts,  when  fit  for  duly , 1230 

disability 1236 

(lisposii  ion  of  healt li  records ;.:;;;. 22fi5, 22S1 

enlist cd  men  of  Hospital  Corps -"J ^80, 431 

entered  in  abstract  of  health  record - •  IV.'P.i'.  '■ 22<>1 

for  disability  by  survey  only 2'.>15 

honorable,  preference  1)ecause  of ■  •  -  •  *132, 2150 

Hospital  Corps  men,  report  of ».J.j...J..      4S7 

(foreign),  certificate  of - , . . >;ri . ; 905 

proper!  y  to  be  returned i  •  ^ .  Mjrf*-.-*.  •  -  •    1466 

ships,  regulations  for 1'27 


INDEX. 

Discharge-s— Continued. 

insane 

medical  survey 

misconduct  report,  Marine  Corps ■.'■'.'..".'.'.. 

Nurse  Corps •  •  ,• 

officer  from  hospital,  to  be  reported 

patients- 
entered  in  hospital  journal 

regulations  relating  to 

ration  notice,  Form  T 

Discipline : 

aboard  hospital  ships 

breaches  of 

dental  officers 

during  absence  of  -ward  nurse 

l-.ospital,  responsibility  for. 

pisease-s: 

among  personnel,  report  of •••■ 

classification  of 

concealed,  to  be  reported 

contagious- 
ability  to  cope  with 

camp  for 

candidate  rejected  for 

care  of 

clothing  to  be  disinfected 

detail  of  pat  ients  with 

in  family,  employees  leave  lor 

in  West  Indian  ports,  report  of 

medical  officer  notified  of 

medical  officer  to  report 

patients  not  to  be  in  landing  force 

patients  not  to  be  transferred 

precautions  regarding •■ 

prevention  of 

report  of 

report  of ,  by  commander  in  chief 

treatment  of 

destruction  of  clothing  to  prevent. 

entered  in  hospital  journal 

epidemic,  report  of 

former,  entered  in  health  record 

infectious — 

care  of 

medical  officer  to  report 

patients  not  to  be  in  landing  force 

patients  not  to  be  transferred 

precautions  regarding 

prevention  of 

report  by  commander  in  chief 

treatment  of 

nomenclature  of 

origin  of— 

decisions  regarding 

to  be  stated 

precautions  against - 


325 

Paragraph. 

3165,3166 

" 1236 

1242, 1365,3915, 3922, 3972, 4131 

691-699,716 

"■■"""'. 1221,4131 

_.___.. 1362 

'  'la'y}  _i}il  I3a5 ,  1524, 1525 

'""...  3922,3949,4131 

1467 

..'..... 2115,2947 

426 

"'. 871 

1022 

'"  1461 

■■■■""''_. 1281,1285 

2564 

2358,2359 

"       817 

891 

2615,2621 

""'.'. 1981 

812,2782 

1316 

'       1313 

"""_ 2130 

2567 

■ '"_'. 2592 

2561,2632 

1844 

2116 

916, 2807, 2608, 2614-2617 

812 

828,4002 

■ 2513 

[_.. 812 

2536,2956 

1362 

■■ 828,1147 

2241 


=i*'S^:'.V;/i'i'>- 


812,2782 
...  2561,2632 

18-14 

""'"'  ...  2116 

'916,^807,2608,2614-2617 

812 

2513 

"""..... 812 

//__,• 2321-2361 

2821-2837 

825 

815 


326  INDEX. 

Disease-s— Continued.  I'araiTJph, 

iiuaranliuablo  — 

arrival  in  port  with -  - -  -  - 2714 

care  of  patients  with ,^i.^,j,,,«j^..--,^.,^-;.. 27l."i 

llag  while  at  sea --vtr 2716 

list  of „.....^^;p„,^....  2731,2733 

report  of 27;{.'; 

,  ^rejection  lor..... IS*"! 

vmereal.    (Sc«  Venereal  diseases.) 

Sisiufection:  ^ 

and  (iisijifectants ^^::^^/■:r:^••/:r^T•:■■:^::]^^f 2751-2772 

done  when  necessary ^... .......;..- i 2816 

of  clothing  o  f  patients 1316 

plants,  list  of,  United  States  Public  Health  Service _- 27R2 

Disinterring  remains,  expenses  of ..........._. 3437,34);; 

Disorder,  oxecut  i vo  surgeon  to  suppress •  -  ■ 1309 

Dispensary:  .,• 

fiu-nitiure,  appropriation  for 139S 

lu>spital,  regulations  for 1551 

Dispensing,  instruction  in : 137i> 

Disqualifications,  physical  examination 2080, 2081 

Distant  service,  transportation  of  sick  and  woimded 18o(» 

Distilled  spirits,  in  medical  store.s •  801,827 

Divine  services  a1  hospitals ......._........,... 132S 

Division:  ^ ._ 

oommauder —  ^ io\  f 

material  surveys  ordered  by 2969 

medical  svu-veys  ordered  by -,•; 2912 

reports  from  fleet  siu'geon  to I'T;! 

otlicer— 

first-aid  instruction ._...._...._ 1M3, 1821 

inspect  clothing  of  crew ._..._. 2543 

stafli,  dut  ies  of V. ...  ..„\ 1 172 

surgeon— 

duties  of 1171-1173 

r  epor  t  for -  • *  1 '  1 

reports  to  division  commander - • 1173 

>urgeon's— 

atdrilb ..,.,..........^.,.. 9S1-987 

at  quarters .-.•••.■  •.•.•.•.-••- -.•-.••  •.••.•.•.••.•  •  •  •.••.••  • ^^ 

dental  officer  part  of ....^, ,...,„,. y., 311 

Hospital  Corps  part  of '- ...,,,,,..,<, 423 

personnel  of :'■<"''■ ^^^ 

Dizziness,  aviator  rejected  for 2113 

Dressing-s: 

pre})aration  of 133" 

protective,  applied  in  engageiuert l*'**^ 

shell- wound — 

contents  of 1(X)2,  lon:{ 

instruction  in  use  of •.•  — - ^^^^ 

station  - 

battle 1821,1827 

brigade,  local  Ion  of l*i^ 

desfgnnlionof 1*^ 

field 1!*62 

temporary 1'^ 

siirgfoni,  appropriation  for.. .  ' 1308 


INDEX.  327 

^'^-^^  Paragraph. 

modification  of 2520 

posts  of  oflicers  in jgg^ 

book,  Hospital  Corps .__ 14  433 

surgeon's  division,  duties  in. ^.  .^ .....^^. 981-987 

Drink,  inbumboats, impecfionof ■.-.•.•.•.-...-.-.-,-.-.-.->- ,'.9Uii«<t*'...'.^j.'L;^ 2571 

Drinking::  .'..^...'..^....     ,   ... .  .toinl..;)o  h.uJ'Z'"" 

glass,  each  patient  to  have .-.-.-.-.-.-.-. -.-.-.-.-w.---.-.--.-- -...- .l.;i...i......    1519 

water,  e.xamination  of. .... . ... . .  ....-...^...................^.... : 2569 

Drowned,  restoration  of ----.- •.-.-.-.•... .-  -  - ...  - ... ......  - . 1012  1821 

Drowning,  classiflcation  of 2335 

Drug-s: 

entry  indicating  use  of 2812  2825 

habitues,  detection  of : 2063 

enlistment  of,  forbidden 2083 

kept  under  lock  and  key . ; 1453 

loss  of  pay  for  disability  due  to  use  of 804  832  924 

,  ;   morbid  use  of,  rejection  for .  .^ ^^ iggl 

J    report  of  use  of. ...,,jji)o.^j..: 901 

Dryness  of  ship ^ ^^_^^ 2542 

Dues,  hospital  ship  exempt  from .^,  .,,viJi ; 4291-4297 

l>uty-les(SfcLineofduty  and  Not  line  of  duty):  .,,,■,,- 

at  sea,  special  qualifications  for 1910 

aviation,  physical  e.xamination  for ..., , 2113 

military,  of  Hospital  Corps 422 

Nurse  Corps,  where  eligible  for g2o 

persons  unfit  for,  transfer  of 822 

reporting  for,  entered  in  journal 13g2 

special,  officers  detailed  for 1352 

Duty  of: 

battalion  surgeons I844 

brigade  surgeon 1842 

chaplains  in  battle I8O5 

chief  engineer,  hospital  ship 1718  1740 

chief  nurses  in  hospitals , 1441-1470 

chief  pharmacists 443-445 

deck  officer,  hospital  ship 1739 

.    Dental  Corps , 33g 

., ,  dental  officer 1021-1038 

division  staff 1172 

division  surgeon. , . U71-1173 

executive  surgeon,  hospital 1301-1334 

faculty  of  Nuv  ,\l  Medical  School ; ., .iii.i.'«-i..'.s.;.ii 3212  3213 

•r -first  officer  of  hospital  ship • jj.rit,;  ij<aV'i^jf\ .;;. 1717  1735 

fleet  surgeon 803, 1101-1173 

hospital  apprentice — 

as  sick  bay  recorder 473 

in  hospitals 1471-1473 

Hospital  Corps 433 

on  hospital  ships 425 

hospital  phips I702 

master  at  arms,  hospital 1431-1435  1502 

i:   master  of  hospital  ship 171,',  1737  2586 

junior  medical  officer- 
hospital ..:::::::::.; 1341-1353 

Ship - .- ;.:;;.;;;;; 881-8S4 

medical  officer ...;.. : 801-1012,2561-2001,3511-3526 

at  quarters , ggg 


328  INDEX. 

Dnty  of— Continued.  Paragraph, 

medical  officer — 

at  shore  stations 911-938 

fitting  out • 841 

in  battle 868 

in  command,  Naval  Medical  School -'  8211 

in  command  of  hospital 1281-1295 

of  hospital 2581-2584 

of  hospital  ship 2581-2586 

of  landing  partv 2)621 

of  ship 2561-2578, 2601-2618, 2632 

of  station. 2591-2597,2631 

of  the  day 1227 

to  wounded  in  battle 1811 

with  labor  board 2141-2154 

night  apprentice  in  hospital .■.-.■.■.•.-.•.•.•.•.•.•.-.-..•.. 1481 

nurses-  ■     ■»"'»"">■•• 

in  hospital ■ 1441-1470 

superintendent  of  corps 615, 631-<>33 

ward — 145&-1470 

officer  of  the  day -  .-•-•..•.-... 1361-1369 

officers  having  special  duties - .  i''-'  — : 1341-1358 

pharmacist - 443-445,1371-1425 

pharmacist's  mate  of  the  day 1431-1435 

regimental  surgeon 1843 

surgeon's  division  during  drills 981-987 

ward  officers 1341-1353 

sanitary,  of— 

commander  in  chief 2511-2525 

commanding  officer 2531-2546 

fleet  surgeon 2551 

Medical  Department •  •  •    2501 

medical  officer  of  hospital - -  2581-2584 

medical  officer  of  hospital  ship 2581-2586 

medical  officer  of  ship 2561-2578 

special- 
death  while  on 2435 

health  record  of  officer  on 2302 

physical  examination  for 2111-2116 

Dysentery : 

precautions  against - 2603 

Ear  diseases,  rejection  for 1961, 1981, 2079, 2081 

Eatables,  not  to  be  taken  into  wards ..-.:. I'.... 1 1515 

Eating  utensils,  disinfection  of ■....-.-.'J^ 2772 

Edacation: 

of  dental  officers 1021 

standard  of,  for  enlistment 20<3 

Effects  of:  — 

deceased- 
collected  and  inventoried 2414 

discretion  as  to  disposal  of 2417 

sold  at  auction 2415 

disabled  persons,  care  of 2991 

Efficiency  report- s: 

Hospital  Corps 491, 12S8, 3903, 4121, 4131 

Nurse  Cori>s 701, 706 

special 6T2 

Electrical: 

ujiparatus,  rec|ulsltlons  for 3421 

connections  for  dressing  stations 1S24 

EUflblc  U«t  of  laborers 2143 


INDEX, 


329 


Paragraph. 

896,2525 

Embarkation  of  troops 2444 

Embalming 4249-4254 

Emblems  for  sanitary  service 

Emergency-ies:  I46g 

night  nurse  informs  officer  of  the  day  of ^^^ 

preparation  of  Medical  Department  for ■.■.'.;".  ■.■.'3326,' 3393, 3394 

requisitions,  open  purchase ^324, 3543 

ships  at  navy  yards '  mo 

services  in ggO 

supplies  in 

Employees.    (S«€  Civil  employees.)  921,931 

compensation  for  injuries "^    j3g2 

entries  in  journal  concerning .''.'!.    1305 

executive  singeon  to  supervise 970 

financial  dealings  with  patients - 

injured—  1240 

ambulance  service  for _     g^y 

at  navy  yards 13qi 

report  return  to  officer  of  day ^276 

subsistence  in  naval  hospitals ^241 

treatment  in  naval  hospitals 

Employment:  623 

special  nurses ' 131 

In  two  branches  of  service jg45 

Enemy,  savage,  ambulance  party  armed  agamst ^^^ 

Engagement,  reinforcement  of  stretchermen 

Engineer.    (See  Chief  engineer.) 

Engine  room:  Ig2i 

first-aid  appliances  for jg45 

force,  stretchermen  not  detailed  from 

Enlisted  men:  ^ 3706,3707 

aid  from  Navy  pension  fund 1" -""""'-"'.'  3438,3443 

burial  expenses  of 3602,3606,3625 

deductions  for  naval  hospital  fund ■ gjg 

examined  before  transfer 33.5 

expenses  lor  medical  attendance ; "' 3-Qg 

half  rating  of  when  disabled 

Hospital  Corps—  430 

discharge  of 432 

pay  of 2903 

medical  survey  on 

militia—  _ 1268 

checkage  for  hospital  fund j268 

in  naval  hospital ^^^3^  jggg_  2006, 2088 

physical  examination  of _  _      33gg 

on  recruiting  duty,  medical  attendance  for .'...".....'    1213 

pay  in  naval  hospital 2983 

physical  examination  before  transfer 

retired—  2437 

death  report  of 2246 

health  records  for ' ' 1534 

Marine  Corps,  in  hospital 

Enllstment-s:  3922,3951,4121,4131 

abstract  of,  Form  X 2065,2066 

adaptability  of  appUcant  for 2027 

age  of  applicant 2063 

alcoholics,  forbidden 2081 

certificate  of  examining  surgeon 


380  INDEX. 

Enlistment-s— Continued.  Paragraph. 

circulars  relating  to —r- 2041,2042 

cont  inuous-serv'ice  man  physically  disqualified .' , 201ti 

criminals,  detection  of ^ ^ .^. .^.^ f , „ . . .- 2063 

defects  waived  by  department .' —  ;,-•••  2020,2052 

description .,- ■  ■■■:•  2101-210:. 

descriptive  list,  entries  on 2077 

deserters  prohibited 2001 

disability—  ,  ,      .  .  .„ 

entered  on  enlistment  papers ._. ........'._......_..,.,,.. .    2020 

entered  on  Form  X  (rough) „.;..r...    207« 

discharge  before  termination  of 2057 

drug  habitues  forbidden 20(W 

educational  standard  for 20f.2 

entered — 

on  Form  X  (rough) 2021, 2051 

on  health  record 2225 

expiring  in  hospitals SOO^ 

extended—  

health  records r-  -Nr  ,*- 229^ 

make  physical  examination 20«r. 

Unger  prints- 
instructions  concerning 2091-209C,  2097 

to  be  taken ,..,....^ 2012-2097 

former  illness  entered  on  Form  X  (rough) > 207S 

for  special  service,  not  allowed 205i> 

fraudulent,  of  minor 2056 

health  record,  entries  in - 2028, 2077 

history  of  applicants  investigated 200a 

hospital  apprentice 472 

hospital  apprentice,  first  class 462 

Hospital  Corps 427, 181-485 

report  of 487 

hospital  treatment  of  applicants  for 2064 

injuries  entered  on  Form  X  (rough) .,,...... 207S 

insane- 
detection  of -.„..t... .k, ,-,, .*-, 206:i 

prohibited K..,,.,i.....(.y.-.  2001,2014,3112 

inspection  and  inquiry  by  medical  officer 202;'" 

intelligence  and  mental  defects — 2026 

intoxicated,  proliibited 2001, 2014, 20<V 

laws  relating  to 2001-20(Mi 

Marine  Corps 200'. 

marines,  physical  examination  required ,„ ..................  .,.....-.•• 201S 

minors— 

consent  required 2004 ,  2056 

fraudulent 2056 

L  prohibited 2001,2014 

t  termor 2003,2lV..- 

u:it!i  of  allegiance  taken  by  recruit 20.'^l 

outline  figure  card 2101-21i>.'. 

papers,  dlsabilil  y  entered  on 2020 

physical  disability,  to  be  recorded .t^ ,^. ,,.„, 201S 

physical  dl.squaliflcations  for 1961, 3001, a07» 

physical  cxamlnatii)n  for 2011,2088 

pliyslral  examination  required 2011,2018,205s 

reading  and  writing  required .,..., 206.T 

record,  medical  oifirer  to  luako  entries ,,...,,,,, 2050 

recruits  v;iCClnatod  liefore  traasler 20'<2 


INDEX.  331 

Enllstment-s— Continued.  ^  _^  ^^Z>^l^-l^nno 

service  record,  entries  i 
'^  ■    soundness  at  time  of — 


,"""'"   '.„                                                                                                 ..       2017,2028,2077,2081 
service  record,  entnes  in ■••.■.-.-.■••••■•■  •-■••• '        ' 


•  "i  373fi 

may  be  rebutted •. •.-.•.■.-.-.-.-.■.•.-.-.-. -.-••.'^ 

to  be  presumed - --•.--v.yfT.»>^^-- 

special  ratings,  piiysique  for. . . ! —  ._i-f,^,^ii.- • 

statements  made  under  oath -,-.-.- .":.: '2002:2003, 2055 

termor •  ^^^ 

must  be ser\'ed • •-.-.-•.•.-- ••--;• 

time  and  place  entered  in  health  record -■■-..  -...-  •.•.-.-.-.--.■.-.-.>.. 

typ'.ioid  prophylactic  administered :rflt.'!f>iba«>  ■-''' 


^  '    vaccination  to  be  done  immediately 


.  2064 

*'      waiver,  requested  for .,,i,tTi'-i'i»' 'n 


Enrollments,  Naval  Reserve  Force 

Epidemic-s: 

appropriation  for  preventing___  ..812,828,1147 

diseases,  report  of ■  '      ' 

entered  in  journal 


2703 
1147 
2318 


*  2567 

in  West  Indian  ports,  report  of -.-.•.■.■.■.•.-.■.•.■-•---■■•-■-■••••-■•••■■•■■•■""■"  -•-■-■■•■•-■-■-■-'' " ; "    ,,„, 

^    ,  ,.i^.'a.v/--('.-..  4121,4131 

report  of.  "■"■■■•■•■■■•■■■•■■■•■•■•■•■•■•■:.:;;.: .-....;...  1901, 1981, 2079, 2148 

Epilepsy,  rejection  for ............,..-..-,,.-,.,..-  ,         2072  2079 

Epispadias,  rejection  for — .-.-.•  -  -.•. —  - , , .l.  ^». .^ ,      ■ 

Equilibrium,  examination  of  aviators  for ■  •  • 

Equipment 
bulai 
aftei 
landing  force 


ambulance  party— 

after  capture,  retained .,.,  j„ii.,^>;  jR^w,-xi«4w;-i«wi--.    *^ 

..v.,^i,j.i.l,ii.v.iv-.'i-C. --      «o4d 
1824 


battle  dressing  station ...■.■,.■..._._.,..--.-  --•.-.--■  .••.-- - ..-...-HHiy-vUssi^-rfq-Vi-i^'*'  ■ 

horse,  for  mounted  ofTicer 

military  hospital  subject  to  laws  of  war.............. ,.,,.^.si4w- 420o 

Erection  of  naval  hospitals :  •  --•>^i'>''rs .- _; 

Errors  in  health  records ■..,.^v-'.-'';-.s-^> .■■■••-■         ' 

Escort,  armed,  for  ambulance  party —  -  -  -  - ,..,,... 

Establishment  of  Nurse  Corps 

Estimates:  _ 

accompanied  by  statements 

appropriations  for  public  works -. •  •  ■ 1  •  ■  ■  • ^ ^- 

classification  in  book  of -.-.-•.-".••-.        '■•-- ' 

expenditures  to  be  specified  in •  •.-.-.-v-  ■ 

expenses 

ingto ■■": ■" "" " 

Hof>r«t!ii-v  nf  Treasnrv ■ " 

22 

131 
41-45 


,   ..      , 21-31 

laws relatmg to ■••••. '" "  ,- 

made  by  Secretary  of  Treasury -  -  ■ ■ ■ 

maimer  of  communicating —  -:        

of  funds  from  hospitals - •-..-.■•.^- 


preparation  of -. ■  ■  •  •. ...--!--- o^  26 

submitted  to  Congress --.-.--. -.-.st!^.- > 

Evacuation-s:                                                                                                         '■'"  ^^48 

convoys  of ::: ....,.,,,..,-:■■■•■: ^^^ 

distmctive  flag  for -,.--^v.--"k:!T ^~^_ 

neutrality  of ••-■■•  —  • :  —  •■•■■•- -.-...,-(--- ^ 

of  wounded ,  landing  force ■ , 

Examlnatlon-s: 

actmg  assistant  dental  surgeon  for  promotion 

admission  to  Medical  Corps ■. ^^3 

appointment  subject  to ^ 

assistant  surgeon '  -^■' '  «•  HtH>- • 

bacteriological,  by  Naval  Medical  School '■ ^^^ 

biennial,  of  pensioners ^3 

chemical,  by  Niuul  Medical  School 


332  INDEX. 

Examlnatlon-s— Continued.  Paragraph. 

(lelayetl,  rank  in  case  of 161 

enlistment  Hospital  Corps 486, 521 

entrance  to  Dental  Corp? 313-318, 321, 333-335 

entrance  to  Dental  Reserve  Corps 354-356 

fireman,  entered  in  health  record 2233 

for  Medical  Reserve  Corps 241, 243, 254, 255 

health  records  at  hospitals 2228 

Hospital  Corps,  enlistment ■ 486, 521 

laboratory,  reiwrt  of 1152 

microscopic,  of  urine  of  candidates 1955, 1993 

Naval  Medical  School 3214 

no  allowance  for  expanses  of  candidates 258.318,357,485 

on  foreign  stations 1^8, 1939 

passed  assistant  surgeon 162 

pathological,  hy  Naval  Medical  School 3221 

post-mortem,  performance  of 2443 

professional.    (iS^e  Professional  examination.)  ,         ,  .. 

promotion - 1**4 

Hospital  Corps -•'- 486 

to  chief  pharmacist's  mate 511-514 

to  hospital  apprentice,  first  class 521 

to  pharmacist 502-504 

records  of • ^^14 

reports- 
hospital  apprentice,  first  class 463 

Hospital  Corps 4121, 4131 

terminates  if  physically  unfit 1^*25 

water- 
entered  in  journal 2315 

from  shore 25ti9 

Examination-s,  medical : 

iioard  of .:::::::.. 893 

of  employees -  •  -  • -    2165 

Examination,  mental,  preceded  by  physical  examination :;,.".Vi;;-j-  ■;■■■•  ^^^'  ^^  ^^* 

Examination,  physical: 

ability  to  perform  duty  at  sea 1959 

acting  assistant  surgeon 1929 

all  patients  entering  hospital 1367 

applicant— 

for  employment  at  navy  yard 2121-2123, 2141-21.54 

pension 37.->S 

appointment  as  officer 1951 

appointment  subject  to 1924 

assistant  civil  engineer - 1931 

assistant  paymaster •  •  •  • 1927 

assistant  surgeon • 1928 

liefore  transfer 823, 2116 

before  transfer,  entered  in  health  record :'.'...:. ,.  .^ 2202 

board  of,  health  record  entries •  -.r : " " "  ^  '        '  ^^''  ^"' 

Burwau  Medicine  and  Surgery,  to  provide  for • "■  -  •  r- 1^1 

candidates ........ ,..•,..*...  1901-1997 

for  Naval  Academy iJl-'.-'L-'h.. i»7l-19^M«'l-l*»,  »991-1997 

notified  of  result  of '.. 1984 

chaplain ■- 1*'0 

chest  measurements,  table  of 1902, 2fiS2,2iiS4 

compensation  act : 2121-2132,2161-2170 

conditions  causing  rejection 1961, 2061, 2079,2154 

crew,  going  into  commission ^^2 


INDEX.  366 

Examination,  physical— Continued  Paragraph. 

Dental  Corps 1923 

Dental  Reserve  Corps i.^- -- ^-^-> I960 

discharge 2265 

employees,  at  naval  hospitals 2128 

employees,  every  six  months 2125, 2171 

employees,  importance  of 2127 

Employees,  injured 2172 

enlistment 2011, 2088 

apprentice  seamen 2082 

apprentice  musicians 2084 

birthmarks,  rejection  for 2068 

Bureau  Medicine  and  Surgery,  to  provide  for 1921 

care  exercised  in 2061 

circular  relating  to 2042 

chest  measurements  of  adults 2082 

chest  measurements  of  Filipinos 2082 

chest  measurements  of  minors 2083, 2085 

chest  measurements,  variations  from 2081 

color  perception , 2075 

completed  in  every  case , 1 954 

conducted  by  medical  ofBcer 2022, 2059 

defects  curable  by  operation 2081 

defects  waived  by  department 2029, 2052, 2064 

disabilities  entered  on  Form  X  (rough) 2078 

disabilities  entered  in  health  record 2208 

entered  on  Form  X  (rough) 2021, 2051 

face,  deformity  of 2068 

feet  examined  carefully 2069 

females 2108 

fingers  examined  carefully 2069 

fireman,  stature  of 2065, 2082 

Fl  ying  Corps 2107 

former  illness  entered  on  Form  X  (rough) 207S 

hands  examined  carefully 2069 

health  record,  disabilities  entered  in 2208 

health  record,  entries  in 2077 

health  record,  procedure  with 1938 

hearing 2076 

height  o  f  adults 2082 

height  of  Filipinos 2082 

height  of  m inors 2084 

height,  variations  from  standard 2083, 2085 

hemorrhoids,  rejection  for 2071 . 2079 

hospital  apprentice , 522 

Hospital  Corps 486, 521 

hydrocele,  rejection  for 2071,2079 

injuries  entered  on  Form  X  (rough) 2078 

inquiry  by  medical  officer 2025 

inspection  by  medical  officer 2025 

instructions  to  be  followed 1952 

intelligence  determined 2028 

marines  required  to  have 2018 

medical  officer  responsible  for  recruit  surveyed 2024 

to  conduct 2022,2059 

mental  defects,  detection  of 2026 

militia 1913, 1966, 2006, 2088 

naval  auxiliary  service v.^isi: 2089 

Naval  Reserve  Force jHOUU-i-'i 2107 


334  INDEX. 

Kraminatlon,  physical— Continued.  Paragraph. 

«'-    enlistment  in —  

f  not  determined  on  finding  defect .-.-...-.  .-.*.-.-.-.v.-.v.v.v..v.v.....-.v.'M 2023, 2060 

■:  nurses 072, 1934 

'  physical  disability  recorded 2013 

physical  disqualifications,  list  of 2079, 2080 

physiognomy  of  applicant ,^068 

plan  of 2061 

procedure  when  rejected 1942 

reexamination  on  receiving  ship 203() 

required ...-...•..-.-.•..•.....•/ 2011,2018,2058 

service  record,  entries  in ...•.■.■.■.■..•.•.•.•.•.•.•. V.'l 2077 

special  ratings,  physique  for .V.  :.:':i^n'.Vil  j/.T.'. 2067 

1  standard  to  be  high ...-...■.•..  .-.•.•.-.•.■... 1953 

.supplementary  for  nuises 672 

teeth  required 2073 

testicle  absent,  rejection  for ...  .• 2072 

to  be  completed 2023, 2060 

'  •  urinary  analysis  required 19.55 

r  varicocele,  rejection  for 2071 

I ''  varicose  veins,  rejection  for 2071 

i  vision  examination 2074 

J  waivers,  request  for 2029, 2052, 2064 

I  '         warts,  rejection  for 2068 

»■  weight  of  adults : 2082 

weight  of  Filipinos 2082 

weight  of  minors 2084 

weight,  variations  from  standard 2083,2085 

entered  in  health  record 2286 

failure  to  pass 165 

for  aviation  duty ; ;...;....-..; 2113 

for  gun  pointer .- ;.......■ 2111 

for  fireman, third-class 2112 

.      Flying  Corps ; 2107 

I     for  special  duties 2111-2116 

f-     general  court-martial  prisoner ; 2114 

_  1     health  records,  procedure  with 2214 

i     hearing  required 1959 

i  •.    height,  table  of 1962 

'■     injured  emjjloyees 2172 

■■.    machinist .■ 1932 

(-    medical  officer  governed  by  instructions 1991 

,-     Medical  Reserve  Corps 1922  1960 

<      men,  before  transfer  • 29.83 

:.    militia 1913,1966,2006,2088 

naval  auxiliary  service 2089 

<■     Naval  Reserve  Force ......•..-.-.■. . .  131 

^     Tiavy-yard  service .-.'.".'iVI"..  2121,2176 

.      nurses 672,1934 

"ilicers 90s 

oilicers,  for  promotion 1909-1912 

paymaster's  clerks.  Marine  Corps 1935 

precedes  mental  and  professional 172, 1925, 1940, 1951 

l)rcliminary,for  Naval  Academy .;:..... 4. 1. 1984-1986 

promotion  in  Murine  Corps .;.... 1937 

promotion  in  Navy.  I 193ft 

,      lecruits 'ra,941-952 

!      statement  by  candidate  under  oath 1958 

hupplementary  for  nurses ..-.".. T.I .'..'.'.. 673 


IISTDEX. 


335 


■paragraph , 
2115 


Examination,  physical— Continvied. 

transfer  to  disciplinary  ship ■  '•  -  -  -  •  i  ■ -----»^ •  •' 

vision—  .   .     1959 

required - ■ ■•  ^ggg 

standard  for  admission jgg2 

weight,  table  of 

Examination,  professional :  ^^ 

failure  to  pass -. ...-- ...--.-. -•••■• ■■■.■-■"■.■  V';;;'j9^'i940  1951 

preceded  by  physical  examination '[cio',"!'!"  "'•':" 

promotion  of —  fv.rtf'  191-193 

assistant  surgeons ".■"'■■■ 201  202 

passed  assistant  surgeons '  ^^^ 

surgeons 9Q5j 

Examiners,  civiUan,  Form  X  (rough),  prepared  by 

Examining  board-s:  ^22  174 

composition  of 121  171 

convening  of jgg3 

decision  to  be  final ■" " ' '  ^^ 

meeting  places  of ■  •  ■ ■ ' ^9^ 

merit  roll  forwarded  to  bureau '  ' '  ■' ^^^ 

organization  of ^^3  j^y- 

procedure  of 2733 

Exanthemata,  quarantine  for 

Executive  oflB.cer:  2548 

iuformation  as  to  physical  capacity  of  crew ^^^ 

report  by,  after  battle 

Executive  surgeon:  ^3^2 

absentees  reported  by ■ ' ' '   '■  jg^^ 

authority  of,  in  hospital --.--- -  ■;";X'' 14^5 

breakage  reported  to -  • • ^30^ 

care  of  patients  by ^443 

chief  nurse  to  confer  with 

.'--ConsuUation-  i:;07, 1342, 1350 

J   '  ■        by  junior  medical  officer ^^^o 

detail  of  convalescents  for  work ^3^ 

diet  lists  submitted  to J342 

directions  of,  to  be  obeyed - j3Qg 

disorder  suppressed  by 1:501-1334 

duties  of "  1333 

as  officer  of  the  day ...-...--.. -  -  r  -  -, ^^^^ 

junior  medical  officers  assigned  by ^^ 

employees  su  pervised  by • ^g^g 

'      inspects  hospital  daily • ' ' ' '    jg^^ 

junior  medical  officer  to  mspect  wards  with ..--'- 

liberty-  .  1311 

book  kept  by 1344 

lists  submitted  to I-^JH 

passes  Issued  by 13Uj 

permission  to  leave  granted  by :.' — ".• 

report-s-  '  1284 

of  condition  of  patient •-' ".■■""'."." 1467 

of  sick  sent  to .■:.'-■.. ......  .^---  -  - ■ ^^^^ 

requisitions  supervised  by ■"  •  ■  - • ; '    ^^^^ 

returns  supervised  by 13jj2 

uniform  prescribed  by jJtii-4297 

Exemption  of  hospital  ship,  from  dues  and  taxes. .....;.. ■■••-•-• 2217  2234 

Exercise,  periodical  physical,  health  records ■■""/.■.".■■      ' 

Expeditionary  service:  2264 

nealth  records -— ----         ^'"•'- ^"^yisil-lSbO 

landing  force  for 


336  INDEX. 

Expeditionary  force:  Paragraph. 

health  records  on  loose  leaves ^852 

marines — 

baggage  allowance 1**^ 

service  with - ^847 

supplies  for 3551 

Expendltnre-s : 

analysis  of,  in  bill  book 1397 

entered  in  bill  book -.-err 138(,1388 

from  naval  hospital  fund,  objects  of 3671 

items  of,  to  be  specified 31 

medicalstores "^^ 

property— 

accountability  for :  mt^t  -,irr ^^ 

hospitals ■ 1371 

public 3521-3525 

vouchor,  for  commissary  ledger 3966 

Expenses: 

bringing  home  remains. , 3400, 3439-3443, 3455 

candidates,  no  allowance  for 128, 25S,  318, 357, 485 

care  of  insane 3154 

estimates  for 21 

funeral 2105,3157 

laws  relating  to 3441-3443, 3451-341.0 

olTicer 2402 

public  bill  for 2404 

report  of 2407,4131 

interment 2403, 3453 

medical  ittondance 3351-3357, 33G1-3305 

patient  in  civil  hospital 824 

quarantine ^3. 2741, 2744 

transportation  of  insane 3156 

remains 240^- 

sick  to  hospital 2944 

traveling,  Nurse  Corps 'J24, 721 

Eiploslon,  traumatism  by 2335 

Exposure  of  crew,  to  be  avoided 2543, 2009, 2C21 

Expressage charged  against  "Freight,  .S.  A  A." 3400 

Extension  of  enlistment: 

examinat  ion  required 2086 

health  records - 2294 

Eye-s: 

color  entered  in  health  record 2241 

scaleof 2103 

diseases,  rejection  for 1901, 20?i> 

injury  to * 21t>9 

prevention  of 2120 

sight,  examination  of  gun  pointers 974, 2034, 2111 

standard  for  admission 19f'3 

witnesses  of  accidents,  report  by 2816, 3756 

Fabrics,  disinfection  of ; :- - 2768 

Face,  deformity  of,  ri-joction  for -- • 20t>S.  2079 

Faculty,  Naval  Medical  School,  dut  ies  of - —v. . , 3212, 3213 

Fall,  traumatism  by 2335 

Families : 

oHicor's,  medical  attention  to '''3, 9U 

services  of  nurses  for ''"1 

Fatigue,  excessive,  to  be  avoided 2ti2l 


INDEX.  337 

Feces:  Paragi-aph. 

disinfection  of 2753 

method  of  preserving 3225 

Feet: 

conditions  of,  interfering  with  marching 1844 

diseased,  candidate  rejected  for 19^1 

examined  carefully - 20tj9 

fixst-aid  care  of  vcounds  of 1011 

flat^ 

candidate  rejected  for WSl,  2069 

degree  of,  stated  on  rejection  report 2085 

entered  on  health  record 2241 

examination  for 1984, 2061 

Felony,  evidence  of,  cause  for  rejection 2079 

Female  laborers,  rating  of 2146 

Field: 

dressing  stations 1*^2 

hospital,  location  of 1^67 

Medical  Department,  organization  in 1861-1869 

officers,  baggage  allowance  for 1847 

supply  table ^^^ 

Figure  card,  preparation  of - 2101-2105 

Filing  requisitions  and  vouchers 1386 

Filipinos,  height,  weight,  and  chest  measurements  table 2082 

Filling  material,  classification  of 2271 

Financial  dealings  with  patients  prohibited 434,970,1260 

Fines: 

appropriation  of,  for  naval  hospital  fund 1203, 3603, 3654, 3658 

transportation  of  discharged  prisoners  paid  from 3611 

Finger-s: 

deformed,  rejection  for 2070 

prints,  apparatus  supplied  by  Bureau  of  Navigation 2096 

for  officers 2097 

instructions  concerning 2091-2097 

taken  on  enlistment 2012 

Fire-s: 

and  rescue  party 984 

apparatus,  care  of 1321 

bill,  to  be  posted 1321 

control  stations,  first-aid  appliances  for 1821 

drUl— 

at  hospitals 1289,1345,1369 

on  shipboard ^83 

for  comfort  of  crew - 2538 

Firearms,  traumatism  by 2335 

Fireman: 

examination  for,  entered  in  health  record 2233 

minors  not  recommended  for 2065 

physical  requisites  for -  -  -  •  2065,2071 

Fixeproofing  clothing  for  battle 1825 

Firerooms,  first-aid  appliances  for 1821 

First-aid: 

ambulance  j)arties  prepared  for 1854 

appliances,  distribution  of 1810, 1821 

instruction 455,818,849,909,1001-1012,1804,1810,1813,1814,1821 

service  during  battle 1822 

First  officer  of  hospital  ship,  duties  of 1717, 1738 

Fiscal  year,  hospitals 1397 

Fistula,  candidate  rejected  for 1961, 1981,2079 

98601°— 17 ^22 


338  INDEX. 

Fitness:  Paragraph. 

for  promotion,  onus  of  establishment l*^" 

reports  of 179,3981,4131 

Fitting  out,  duties  of  medical  officer •• 8*1 

Flag: 

distinctive,  for  hospitals,  ambulances  and  evacuations 4208 

hospital,  Iwats  to  carry 1^^ 

Hospital  Corps  detachment  to  have - 1846 

national,  displayed  with  Rod  Cross  flag 1846,4208 

quarantine,  hoisted  while  at  sea 2716 

Red  Cross- 
brigade  haspital  designated  by,  daytime,  at  night  lantem 1868 

description  of 4222, 4249 

displayed  by  sanitary  formations 1845 

displayed  with  national  flag 1846 

dressing  stations  designated  by 1865 

hospital  boat  to  carry 987 

regulations  for  use 4252-4254 

Fleas,  destniction  of r 2781 

Fleet,  organization  of ?oi  *>jj?fcVA 1841 

Fleet  staff  (See  Commander  in  chief):  — 

regulations 2579 

Fleet  surgeon: 

appointment  of n^l 

as  brigade  surgeon H^l 

bills  of  health  obtained  by !;'.''i- 2743 

bulletin  to  be  issued  by 1163 

consultation  with  medical  oflicer - ;.•..•.,.-.....  ,s.i.i.  .u 1134 

correspondence ^  * 1131 

dutiesof 803,1101-1173 

embarked  on  flagship ,.,,.,,,,,,,,, ^.->  ..>  i. .,  i 11 12 

flag  officer  on  special  duty ■^^» ;.y, v<{  -H;.  ,:j. :i.'. ..; 1121, 1122 

Form  K  forwarded  through -•••    2372 

health  records  inspected  by 2219 

inspection— 

of  medical  department 11"'2, 1162 

of  naval  hospital - --••-• ..,,,,.,..,,  ,t?. 1136, 1252 

sanitary ' H^S 

inspects  ship  when  ordered 1113 

laws  relating  to «.ij,;i,^<^v,i.;,.> 1101,1102 

me<iical  surveys  approved  by 2913 

papers  referred  to  by  chief  of  stall r 1 139 

reports ^m 

approval  of > 1 138 

of  death  forwarded  through -  ,>-~'.tio- 2432 

of  killed  and  woimded 1137, 1808 

returnable  through •  •  •  r 1141-1 1 54 

sanitary 1138, 2633 

submitted  to  commander  in  chief .-, » 11*0 

requisitions •  •  •  • 1131 

returns  approved  by ■ « • '  —  ••  •  •  •  •  • 1138 

sanitary  duties  of 2561 

Fiiggesliona  to  commander  in  chief ....,,,,,,  .^..Vij.b^woA-  'r  <  <  i..-.- 1135 

transfers  of  patients  reported  to ,f^,,,,ffj^*«-uoi  i 2986 

Flies,  protection  from — 2616,2621 

Fluorld  of  sodium,  use  as  insect  icide 2781 

Food-8  {See  Provisions): 

cooking  of 2544 

In  biimboals,  inspection  of ^ •  -^ 663,2571 

Inspect  ion  of 820, 860, 853, 2565,  '2571 


INDEX.  339 

Food-s— Continued.  Paragraph. 

precautions  when  in  camp 2621 

precautions  when  night  soil  is  used 2604 

preparation  of. Sol 

wholesomeness  of 2.544 

Foot.    (S^eFeet.) 

Force: 

auxiliary  naval,  pensions  for 3727 

expeditionary,  marine,  service  with 1847 

landing — 

for  expeditionary  service 1841-1869 

Foreign: 

countries,  funeral  expenses  in 3452 

liospitals,  certificate  concerning , ,  .„.,,;j,  vuiMj^-i-jiv  oi/i' : ^05 

naval  medical  establishments,  report  on .....'................... 2654 

ports,  report  to  Office  of  Naval  Intelligence 2566,26.55, 2661 

sanitary  data  from 829,2656 

service,  pay  of  nurses  on 723 

stations,  examinations  on , 178, 1939 

public  bills ^[.l....^. 3402 

Foreman,  hospital,  report  to  executive  surgeon 1.542 

Forfeitures: 

desertion,  disposition  of 1204 

•  to  naval  hospital  fund 3609,3657,3658 

transportation  of  discharged  prisoners *. 3611,3658 

Formaldehyd,  disinfection  by 2752,2765,2768-2770 

Formalin: 

;      disinfection  by 2753,276,5 

preservation  of  specimens  in 3225 

Form-s,  Bureau  of  Medicine  and  Surgery: 
blank — 

list  of .......J.-.;— vJ^--;-t:-vv 3922 

instructions  regarding ?.! 3901-4«02 

object  of  ui;ing 3921 

request  for 3922,3945,4121,4131 

,      B,  requisition  and  priced  invoice 3375, 3396, 3922, 3931, 4121, 4131 

J     Ba,  special  requisition fj,^p.y^^.,-j.j.r.,^jj^tp_..j,^.,..^.y>... .^.  3353,3922,3932 

C,  survey  of  material ........"/..' .'..' .' 1...^,. .  2961-2978, 3922,  .3934, 4131 

;  -   Ol,  survey  of  material 2961-2978, 3922* 

;.     Ca,  survey  of  material 2961-2978, 3922, 3934, 4121, 4131 

Ca-1,  survey  of  material 2961-2978, 3922 

D,  inventory  of  property 3522, 3922,3935,4121,4131 

Da,  inventory  of  property 3922,3935,4121,4131 

F,  quarterly  abstract  of  patients 3922,3936,4121,4131 

key  letters  required  on 3325, 2327, 2337 

;      F  (rough), cards 3922,3936,4121,4131 

,  entries  by  officer  of  day .'. .  -y{- ijr ■  •  •    ^^'^ 

expeditionary  forces 'y^J^^.  ^. 1852 

preparation  of ,.:,^„^:....:,^^^^^^:^^^y^:^^;,,.„^^, 2367 

a,  hospital  ticket 1 .3922, 3937, 4121, 4131 

H,  health  record 3|922, 3938, 4121, 4131 

dental  record  for  insertion  in .- 3922, 4131 

syphilitic  abstract  for  insertion  in 2307 

1,  weekly  report  of  sick 3922,3939,4131 

K,  statistical  report  of  sick 3922, 3940, 41^,  4131 

preparation  of . ....i.....  2371-2391 

record  of  dental  treatment ............-.-..■.-.-.- ^.v. 2270 

vaccination  entered  on 2086 

Ki,  report  of  killed  and  woimded  in  action 810,3922,3941, 4111,4112 

'.il't.         ....  .■  ij'.  LiiJi/,.!'-  ....  J 


340  INDEX. 

Fonn-s,  Bureau  of  Medicine  and  Surgery— Continued.  Paragraph. 

L,  request  for  iiieJical  siu-vey 2921-2925,3922,3942, 4121,4131 

M,  report  of  medical  survey 2931-2937,3922,394.3,4121,4131 

N ,  report  of  dcatli 825, 3922, 3944,4121 ,  4131 

preparation  of 2401-2443 

0,  request  for  blank  forms 3922, 3945, 4121, 4131 

P,  report  of  operations 3'.^22, 3940, 4121, 4131 

Q.  clinical  chart 3922, 3947, 4121, 4131 

S,  ration  notice  (admission) 3922,3948,4131 

T,  ration  notice  (discharge) 3922, 3949, 4131 

V,  return  of  medical  stores 3922,3950,4131 

X,  abstract  of  enlistments 3922, 3951, 4121, 4131 

preparation  of 2051 

preparation  of,  at  marine  recruiting  depots 2053 

X  (rough),  cards 3922,3951 

disabilities  entered  on 2078 

illnesses  entered  on 2078 

injuries  entered  on 2078 

physical  examination  entered  on '. 2021, 2051 

Y,  abolished — ....... .  .• 

1,  requisition  for  supplies 339C,  3544, 3922, 4131 

4,  requisition  for  supplies 3375, 3396,3544, 3922, 4121, 4131 

5,  public  bill 3922, 4131 

6,  public  bUl 3922,4131 

eflacicncy  report.  Hospital  Corps 491 

qualifications  for  promotion,  Hospital  Corps 3954 

Form-s,  Bureau  of  Navigation: 

1 ,  service  record 2095 

2,  finger-print  record 209<i 

54,  report  of  rejection 20f>4 

used  in  hospitals 3981-3985 

Form-s,  Bureau  of  Supplies  and  Accounts: 

84,  pay  roll 3962, 3992, 4131 

used  in  hospitals 3991-3999 

Form-s,  Civil  Service  Commission ...".. ...■.■.•.■....•.•. 1642, 2144 

No.  1800 :'!://{'. I^^?::.::. 2152 

Form,  Department  of  Interior,  for  admission  to  hospital 3129,3130,4001 

Form-s,  Department  of  Labor: 

C.  A-lb 2175 

C.  A-2b : 2175 

C.  A-3a 2175 

C.  A-4 21 72 

Form-s,  Marine  Corps,  No.  330 2095 

Form-s:  '^^' 

kept  by  ward  nurse .... .'.'...■.■.■.".■.■.■.. 1467 

notation  on 3'J3i> 

special,  used  in  hospitals 4001,4(X)2 

•ward,  kept  by  ward  officers 1342 

Fort  Lyon,  Colo.,  instead  of  Las  Animas,  court-martial  prisoners  not  sent  to 1207 

Fractures: 

first-aid  care  of 1008 

of  vertel)ro,  rejection  for 2079 

Fraudulent  enlistment  of  minors '......... 2(Vj(i 

Freight,  S.  &  A.,"  charges  against 3400 

Fruit:  

not  to  bo  taken  into  ward ... .......^ ......^ 1515 

precautions  concerning 2621 

Fuel  allowance: 

Nurse  Corjis 619, 751 

temperature  certiflcalo 920 


INDEX.  341 

Paragraph. 

Fumigation  plants,  United  States  Public  Health  Service  list  of 2782 

Funds,  estimate  of,  from  hospitals 4131 

Fund,  Naval  Hospital: 
appropriation — 

by  Congress  for 3607,3655,3661,3662 

of  fines  for 1203 

charges  agamst 3383, 3399 

checkagefor .• 731,1202,1208,3602,3606,3621,3624,3625,3651 

credit  for  desertion  forfeitures 3609, 3657 

disbursements  from 75 

entry  in  bill  book 1397 

expenditures  from 3671 

fines  appropriated  for 3G03, 3054, 3658 

forfeitures  for  desertion 1204 

history  of 3631-3645 

militia  not  checked  for 1268 

origin  and  uses  of 3631^3645 

payments  for  subsistence  of  employees 3614, 3657 

pensions  paid  to 1535,3605,3623,3653,3656 

proceeds  of  sale  of  hospital  property 3613 

, ,      ration  allowance  to  naval  hospitals 3604,3622, 3652 

sources  of  revenue  to « 3661-3603 

Fund,  Navy  pension: 

aid  for  disabled  enlisted  men 3706, 3707 

charges  against 3784 

collections  for  depredations 3708 

history 3702, 3780 

information  regarding 3701-3797 

interest  on 3704, 3780 

investment  of 3703, 3781 

penalties,  how  sued  for 3702 

pensions  payable  from 3704, 3783 

Secretary  of  the  Navy,  trustee  of 3701 

Funeral:  .Ut)UfgoH  -  »»»>    .on 

expenses 3157 

laws  relatmg  to 3-131-3444,3451-3460,3461 

of  officer 2402,2405,3444 

public  bill  for 2402 

report  of 2407, 4131 

services  at  hospitals 1323 

Furlough : 

sick,  pension  status  when  on 3729 

veteran,  pension  status  when  on , 3729 

without  pay,  disposition  of  health  record  on , 2296 

Furniture : 

dispensary,  appropriation  for 1398 

hospital — 

appropriation  for 1398 

changes  in .,.,. 1283 

nurses'  quarters, supplied  by  bureau ....i..., ; .  -752 

operating  room,  requisition  for :3421 

quarters,  appropriation  for i,^.^-,i,.  ..,4,<^.,. ,  1398 

Fuis,  dismfection  of .nji..u,.^i.,iHJv.* :  2769 

Galley,  medical  department  use  after  battle ; 1828 

Games,  playing  of,  in  wards 1509 

General  court-martials: 

medical  certificate  on  proceedings  of 897 


342  INDEX. 

General  court-martiat-s— Coatinued.  Paragraph. 

i>risoners — 

medical  survey  of ■. ,  2947 

not  sent  10  Fort  Lyon,  Colo 1267 

physical exaniinut ion  of iJlll 

Oeueral  qaarters : 

inslmct  ion  of  personnel  during; 1823 

medical oflicers' duties duringi...; .;;......-  1823 

station  during .1. '..:!;..: ;::::::::..  869 

surgeon's  division  station  during 869 

Ce  ueva  convention : 

nations  participating  in : 4201 

of  iSftS,  provisions  of .:::.:::::::::::: : . .  ..:',■-•--•■  4211-4225 

of  1906,  provisions  of :::::.-:::::::...*:?.:...  ^  .  ."1851,4231-1265 

'        original,  provisions  of ;.;.;:;;:::;-.:: -.::ttt::::-. 4202-4209 

ratification  of .;:;..:-.;;.: ::::::::::?: 4225 

:-:iispension  because  of  abuse ...;::;: . .  4224 

Genitalia,  iieculiarities  of, entered  in  health  record.;;:::;;.;;.;.:::: 2241 

Genlto-orlnary  organs,  rejection  for  disease  of — :::;: ::;:;..'.  1981,1981,2079 

Gifts  in  Did  of  marine  hospitals ;;:;;-•;;;..  :<fi01 

GUsonlte ;:::::::;:.... 2097 

Glass,  drinking,  each  patient  to  have ;;;;:;:::;.;:::?'. 1519 

Going  Into  commission: 

duties  of  medical  officer 841 

invoices  of  stores ::::::::f^ 3501,3512 

vaccination  of  crew 2576 

Going  out  of  commission: 

Form  K  prepared 2371 

invoices  of  stores 3518 

journal 4121 

medical  outfit -..-.- ;;; 864,3334,3904 

microscopical  outfit '. 864,321)4 

Gold  work,  not  duty  of  dental  officer .............-.■..■.■....; 1033 

Gonorrhea,  rejection  for .-.  .-.■.■.•.-.•. .  ..■.•.•.■.■.-.•.-.•. 2079 

Government  Hospital  for  the  Insane.    {See  St.  Elizabeths  Hospital.) 

Government  of: 

-Vaval  Asylum 1206 

naval  hospitals,  regulations  for ....■.•.•.-..•.•.■.•.•.•.■.■.•.•.■.•.•.•.■.•..-.■ 1239,1282 

Governor  of  Naval  Home,  patients  report  to — 1214 

Grades,  abbreviations  for 2241 

in  Kaval  Keserve  Force 131 

Gratuity  pay: 

relationof  lineof  duty  to 2841-2852 

to  designated  beneficiarj' '.'»0l,2431,;U5l 

uniforms,  for ■.-.•.i-.-.-.-.-.-.-.-.-.;;-...  131 

Graves,  unmarked,  hea<lstones  for 1202.4131 

Green  blindness,  determuialion of -.-.....•...-.-.•....•...■..•.■.•.■.■.-.-.•.■.■  ...OK   .  2075 

Grounds,  hospital: 

no  changes  to  bo  made  In —  Il'24,  1283 

weekly  Inspection  of 1285 

Guardian,  consent  for  enlistment  of  minor  .-  2004,2056 

Gun: 

pointers,  oyosighl  e.Yamlnation  of '.i74. 30.14. 211! 

stations,  first-aid  appliances  for 1^21 

Gunnery  record,  vLsioii  fxamirmt  ion  entered  on 2111 

Hague  Peace  Conference: 

of  iHtd) ..  4271-4S«? 

of  1907...  isv,,ivr.i..|.wt-.t;wi 


INDEX. 


343 


Paragraph. 

2241 

2103 

3706 


1981 
2081 
2070 
1821 
137o 


1292, 4131 


JtTQl 


.iOlSDSJi !i-V21 


Hair: 

color  of,  entered  in  health  record •  ■  ■  - 

scale  of -■•  •  • •  •  • 

Half  rating  of  disabled  enlisted  men -  •  -  ---  -  - 

Hammertoe: 

candidate  rejected  for 

entered  on  rejection  report 

Hands,  defects  of,  disqualifymg  for  enlistment 

Handling  rooms,  first-aid  appliances  for 

Handy  Book  for  Hospital  Corps,  method  of  obtaining. . . 

Harbor:  ,       ^  ,  ^.t^lfn  ;;•..' 1735,2585 

regulations  to  be  observed 902  2425,2603 

water,  use  of,  on  deck • =.^ .»»..». v .. .  ,         ^^^ 

Harelip,  rejection  for ....---- ^^^^ 

Hats,  disinfection  of ' ^^^ 

Hawaii,  fiuieral  expenses  of  officers  dymg  in. -  ■  -- 

Headstones  for  luunarked  graves • ■'-■■^•^' 

Health: 

bUlsof.    (See  Bills  of  health.^  

control  of  conditions  affecting — — *• 

'  802  2543 

crew,  consultation  concerning ' 

crew,  preservation  of V  i  y,  ,      " '    2525 

embarked  troops,  precautions ""''''"'"''"' "^,* " " '    2607 

ports  to  be  ascertained ::^^u^Ll^J"Z'^^^"'.^^,m2 

ports  visited ,^^,.,.^—^.^i^^.^  ^J— 

officers-  ""^i-^^L.7"\ 2712 

facibties  aflorded  to -"-*  ■  "^  ^  2722 

received  by  medical  officer ......j,:.. ^^ 

precautions  in  Tropics ^701  2708 

public 857  962 

Health  records 

abbreviations—  ; '. ' :;  „„,, 

for  grades  and  rates 2284 

on  margin 

abstract — 

entries  on 

procedure  on  promotion . 

procedure onreenlistment """"""".  """m'^"      h '■'-         2307 

syphilitic  treatment ..*'.l.vij.u>.»  i^u.vj, .  i^. ^^^ 

accidents  noted  in " " " ' ' 

accompany  patient  on  transter ^932 

to  hospital 2261 

admission  entered  in  abstract ^^^^ 

admissions  from 2249 

approval  of  entries — 

Army  transport 

board  for  physical  examination 

breakage  to  be  avoided 

care  in  keeping 

change  of  diagnosis 

commanding  officer  to  approve 

completed,  sent  to  bureau 

compUcations,  method  of  entering ^^^ 

condition  on  discharge  noted  in •■; ' 

date  of  transfer  entered  in "^~''""n"  ""■''"-' 2267-2271 

dental  record ..'..:.;  jcl.  .. . . . ...... 

,         . i.jaz0.3tiiiu4 ..     2291 

deserters •  ■ 2203, 2282 

destruction  of,  procedure 


2253 
2262 


2213,.2214, 2251, 2266 

.u.;iUi0Wft.  2287 

...-.-..'-2231 

„,^ 2284 

^ .iif.A.r.'js.'niS'Jp-T/i.u.- 1286, 1343 

2223 

, 2258 


344  INDEX. 

Health  records— Continued.  ParaRrapb. 

directions resanliiig 2281-2294 

disability  entered  on 2208, 2250 

disposition  on  discharge 2265,2281 

enlistment,  entries  made  on 2225 

entries 918,2028,2241, 2249, 2254, 2260,2283 

indicating  use  of  intoxicants 2218 

on  admission 2250 

on  transfer 2992 

to  be  concise 2260 

errors  in 2307 

examination  before  transfer  entered  in 2202 

for  fireman  entered 2233 

exammed  at  hospital : 1226, 2228 

example  of  data  required 2285 

expeditionary  force i. , 1S52, 2264 

on  loose  leaves 1852 

extension  of  enlistment 2294 

FormH 3922,3938, 4 121, 4 131 

forwarded  on  transfer 2266,2281 

to  bureau 2266, 22S1-2290 

furlough  without  pay,  entries ^ 2296 

grades,  abbreviations  for 2241 

injuries  noted  on 2209 

insane  patient 22S9 

inspected  by  commanding  oflBccr l  •. : 2224 

fleet  surgeon .-, 2219 

instructions  for  opening  and  preparing .......:...  224 1-2271 

junior  medical  officer  to  keep KS2, 1313, 2206 

key  letters  required 2325,2326 

left  with  consul 824 

line  of  duty  entry  on 2254,2256, 2259,228a 

loss  of,  procedure 2263, 2282 

loose  leaves  for  expeditionary  force 2264 

medical  officer  notified  of  transfer 2212 

to  keep 2222 

medical  survey  entered  in 2286 

midshipmen 2306 

modiflcat  ions  of 2249 

name  to  be  spelled  correctly 2241 

Naval  Auxiliary  Service 2245 

nomenclature  to  be  used 2257 

no  papers  to  be  attached  to 2286 

notes  of  trivial  affections 2285 

not  in  line  of  duty  entries 2207, 2255 

Nurse  Corps,  custody  of 717 

nurses- 
kept  by  chief  nurse 1445 

opcmug  of 2244 

officer — 

custody  of 2211 

examination  for  appointment 2303 

examlnat  Ion  for  promotion 2303 

examination  for  retirement 2303,2304 

medicallustory 2305 

on  detached  duty 2302 

on  termination  of  appointment 2304 

on  waiting  orders 2302 


INDEX.  345 

Health  records-Continued.  Paragraph. 

opened- 

for  all  persons 

on  appointment  or  promotion 2232 

patients — 

admitted  to  hospitals 2229 

in  civil  hospitals 

in  foreign  hospitals. •  -.  • 

received  for  passage 2221 

to  be  accompanied  by ■ - -.---.-.•.-.-■-- 1229 

transferred,  to  have -.-.-.-.-.•.-.--.:• 2201 

periodical  physical  exercise '-■ 2217,2234 

persons  surveyed 

physical  examination- 
entered  in 

procedm'e  of 

prepared  for  each  person 2242, 2243 

procedure  on — 


824 
2204,2205 


■foMMi,  *£!■■•?- MO. 2286 

1938 


ISO 

promotion ••- ■ ^_ 

reenlistment - "^  '' 

promotion,  procedure  on 2262 

rates,  abbreviations  for ■ '        ■  ■ ^241 

retired  officers  and  men 2246 

senior  medical  officer — 

094c 
responsible  for .1^10 

224Q 

to  approve " 

sequelae,  method  of  entering 2259 

t^     sick  leave,  forwarded  to  bureau 2266 

.     .        ,                                                                               2230 

sigmngof 

State  hospitals,  CaUfomia ^^°^ 

sfagglers •-••• 2247  2293 

supernumeraries ' 

supervised  by  officer  of  the  day "63 

symptoms-  _  _ 

notedm 

not  used  as  diagnosis "^ 

syphiUtic  abstract,  inserted  when  necessary 230? 

teeth,  entries  concerning 2271 

leeiu.c  .  .  ^^^,_--,  2225,2261,2281,2284 

transfers,  entries  made  on '        '„„'„„„ 

~^        ,      .„^  ;„  2260,2283 

treatment  noted  m ' 

tvphoid  prophvlaxis  entered  on lyjo, ,  ££i, ,  uoo 

lamination  entered  on 2086,2226,2253 

venereal  disease  entries ■ ^  3230  2230 

verification  of ' 

vision  examinations  entered  on ;,"""'" Anro  ooJi 

waivers  entered  on • 00,=  ,266 

where  no  medical  officer /-/i^/zoo 

Hearing: 

defective — 

entered  on  rejection  report 

examination  for ' 

^     ^.       .  1901.1981,2079,2148 

rejectionfor '  ^^^ 

entered  in  health  record ■ ; 

examination  of,  for  aviation 

requirements  on  examination  for  promotion 

standard—  g^ 

admission  and  promotion •■• 

■ '"TtcJ^Sr^"""' :::::::::::::-i9si:i995,S2?;6 

voice  and  watch  test  lor '        ' 


2081 


846  INDEX. 

Heart:  "    '      '    Paragraph, 

disease — 

examination  for 1984 

rejection  for 1961, 1981, 2079, 2148 

Heat,  exposure  to,  to  be  avoided 2621 

Height:  

disproportionate  to  weight. ..:.... .... . . .... . .-. . . . ...... ..-...•...'.■. 2083, 2085 

employees,  table  of v 2152 

entered  on  descriptive  list ; 2103 

health  record 2241 

rejection  report 2081 

midshipmen,  requirements  for 1982, 2084 

tables  of 1962,2082,2084 

for  women 2801 

variations  from  standard  of 1962, 1982, 20S3, 2085 

Hemorrhage: 

control  of lOOi,  1005-1007, 1821 

Hemorrhoids: 

entered  on  rejection  report : 2081 

examination  of  Candida  te  for ^ 2061 

rejection  lor 1961,1981,1986,2071,2079,2148 

statement  concerning ..ivi.-.ii..;...:. 2081 

Hernia:  ■  ' ' 

entered  on  rejection  repor( 2081 

examination  of  candidate  for 2061 

rejection  for ..^...-.^-- 1961,1981,2079,2148 

History:  • ...j)n;> .»)."..  K.  !«■ 

medical ,  applicants  for  enlistment ....;...;;  J .i  * ..  j  '. 2063 

expeditionary  forces .-. . .  1852, 2261 

patients  in  civil  hospitals i 824 

naval  hospital  fund 3631-364,". 

navy  pension  fund 3762-3780 

Holds:  -■•- 

disinfection  of 2761,2762,2764 

inspection  of 855 

Holmgren's  method  of  testing  color  perception ...-.:.  J. .  .t 207.'i 

Home,  Naval:  ..■..'     ,■•■ 

admission  to 1631-1632 

allowance  of  Imnates 1633 

govenuncnt  of 1206 

olficers  disabled  may  go  to 1221 

patients  report  to  governor  of 1211 

pensions  of  persons  In 1535, 362ii,  8656, 3752, 3801-3806 

survey  to 1632 

Homicide,  injury  by 2335 

Hookworm,  rejection  for 1981 

Horse-s: 

charged  against  contingent,  Bureau  of  Medicine  and  Surgery 3400 

equipment  for  niount('d  oflicor. 1847 

Hospital  apprentice-s,  second  class:  

detail  of,  to  assist  dental  surgeon 474 

duUes  of 438, 433 ,  473 

enlistment  of 411-413,423,521 

examination  for  enlistment  as 4.U, 483.521 

pay  of .....ij..t..-..t 403-401' 

precedence  of 401 ,  406 

rank  of -j • ,.... 401,406 


INDEX. 


347 


Paragraph. 
Hospital  apprentice-s,  first  class :  ^-^^ 523 

acting  appointment  of ""■■'■■..'''■ 411-413, 423,  -181 

enlistment  of ■ '  *.'.'.'.'.'.'.".'.'.'-'-- .'  ...  463, 520, 524, 525 

examination  for  promotion  to -  -  .-'• .■".■■.'.■■. 403, 406 

pay —  •• ■ ■"■'".       .'..."'".. 401,461 

precedence  of •  •  - "  "  " .  523 

promotion  of -  -  - 1591-1622 

Hospital,  Army  and  Wavy,  Hot  Springs.  Art - 

Hospital,  base:  Ig62 

aid  to  wounded  at jg49 

command  of Ig49 

hospital  ship  used  as ; ; ^ggg 

location  of " ' Ig42 

organization  of • 9g7 

Hospital  boat,  equipment  of - 

Hospital,  brigade:  ^^^2, 1868 

aid  to  wounded  at - ^ggg 

designation  of 

Hospitals,  civil:  824 

care  of  patients  in 2436 

death  in ■ g24 

expenses  of  patients  in ".■■■■■■■■".'."".""      .'.'.'.".'. '  -  §24 

health  records  of  patient  sin.... :....-. •--■-■•----■•■•■'""•■■".■■■■"■■.■■. '/VV')"^ g24 

mcdicallnstory  of  patients  in......  :.-..■-■-■•' -"--■•' -yi^ '  "      g24 

reports  of  patients  in ' g24 

transfer  to 

Hospital  Corps:  402 

attached  to  Medical  Department  of  Kavy '      g^. 

attention  to  sick  by 39.-,3, 4121, 4131 

changes  in,  report  of 

chief  pharmacist.    (Stf '-Chief  pharmacist.'")  411-413 

circulars  relating  to ■  • .' ' ' '  \\  ^3- 

classiflcation of •■ '.".' _    j4g5 

detailed  by  ward  muse -  ■  ■  ■ • • '''..'.    1038 

with  dental  officer • .gp  ^g^ 

discharge  of  enlisted  men  of " '       '  ^^ 

discipline  on  board  hospital  ships 14, 438 

drill  book,  issue  of ' " 421'  433 

duties  of  bureau  in  connection  wi  fi :  - .- '  ^    '  ^25 

duties  on  hospital  ships '"401  1153,' 1288, 3963, 4121, 4131 

efficiency  reports  of '"I'yi '  401  483 

enlisted  men  of  Navy  and  Marine  Corps  eligible  for  transfer  to ".■.■.■.■.■.■.'.  42?'  481 

enlistment  in 490,4121,4131 

examination  reports .■  •  • ". '   "  ^    -^^q- 

executive  surgeon  to  supervise 434  970  1260 

financial  dealings  with  patients  prohibited ■:'K'^u       '      '  ^^^^^ 

flag  carried  by  each  detachment -  •  - -.-  ■■.■.■.ifyr-u.-' '.■'•'  -i^-  ■• ''' ^^^^ 

Handy  Book  for,  method  of  obtaining ■■■^■^V^^^.l: -lO^  435  1261 

hospital  and  ambulance  service  by ,-,r-r,TfT-iTfJ!*" ''      '  jyg- 

^ospimsm,rn^rn,ea^.y .:.:. ■;;--;455;9io;i288:i3^i:i375:a4i7:i8i4:i82I,^^^ 

instruction  of •■ ■».)>'        >  isM 

knives  or  shears  carried  by -  -  -  ■ 401-407 

laws  relating  to ^22 

military  duties  performed  by • ^  ^^ ^ 

movements,  report  of wj  rrrtr  riiiYu 'r;.'  \'i':'i  o'rjo.v" " ^^^ 

"nurse"  not  used  as  designation  of ■■--■■•ri-MittiTi-''----     ^^ 

part  of  enlisted  force  of  Navy - ^^^ 

surgeon's  division -■: :;:;;Vi«,406,432 

pay  of 


348  INDEX. 

Hospital  Corps— Continued.  Paragraph. 

pharioacists.    (See  Pharmacists.) 

pouch,  chief  pharmacist's  mate  to  carry l»4ii,  1S04 

precedence  of ■*37 

promotion  in ^"^ 

quarters,  patients  not  to  enter 1517 

report  of  changes  in *^7>  12S8 

efficiency 491,1288 

examination 490,4121,4131 

promotion 4S8 

subsistence 3954,4131 

transfer  to •■--•; *^ 

responsibility  for  care  of  stores -.--.-•.--.•. ^^^ 

service  records -  -  -. '*28, 489 

subsistence  reports 3964, 4131 

term  "nurse  '  not  applied  to 492 

transfer  of  enlisted  men  to ■ 401, 483 

transfer  of  stores ^**^ 

uniforms  to  be  inspected 1326 

Hospital  divisions,  training  of 4353 

Hospital  expenses 1426 

Hospital,  field: 

location  of 1^^ 

organization  of •.::"■.;;■. ^^^ 

Hospital  (foreign) : 

certificate  of  admission  or  discharge - 905 

patients  left  in '  •  2204, 2205 

H  ospital  fund.    {See  Fund . ) 

Hospital,  Government,  for  the  Insane.    (See  St.  Elizabeths.) 

Hospital,  marine,  gifts  in  aid  of 3001 

Hospital,  medical  attendance  in  absence  of 3356 

Hospitals  for  insane,  State  of  California: 

admission  to 3160, 3161, 3163 

deaths  in 2439,3157,3162 

health  records 2289 

insane  in 3151-316G 

laws  relating  to 3141 

papers  for  admission  to 3163 

payments  to 3158, 3159 

report  of  condition  of  patients 3153 

Hospital-s,  military : 

duties  continued  after  capture 421 1 

equipment  subject  to  laws  of  war 4205 

flag  to  be  distinctive 4208 

neutrality  of 4202 

person-s  employed  in 4203-4205, 4240 

Hospital- s,  naval: 

absentees  to  be  reported 1312 

accounting  s  j-stem  of 13!>o-1413 

acting  appointments  expiring  In 1263 

admission  of  patients,  regulations  relating  to 1365 

allotments  on  tmnsfer  to I'TV '^^** 

allowance  of  rations  to 3('rfH 

ambulance  service,  for  civil  employees , , .., . .  ^., 1240 

sor\-ice  performed  by  Hospital  Corps '. 1261 

apprentices  not  to  play  with  patients 1473 

Army  personnel  in 3011 

attendants  atone  available  for  service .,.^. 12:U 

athletic  outfits  provided .....■.■.........".'... 1327 


INDEX.  ^^^ 

Paragraph. 

Hospitals  ,  naval-Continued.  1431,1433 

bag  room  regulations ■■■ 1320 

beds  assigned  to  patients 

bill^-  1258,1319 

book •••  1381,1385-1410 

book,  instraction  concerning 1314 

supervised  by  executive  surgeon .'.......... ^^^^ 

brigs  to  be  visited 3063 

Brooklyn,  N.Y.,  sale  of  land  of 1209 

buildings  authorized  by  Congress 1224,1283 

°         .  iQoq 

changes  in ^•^'^^ 

bulletin  board,  notices  on 3981-3985 

Bureau  of  Navigation  forms  used  m -• 3991-3999 

Bureau  of  Supplies  and  Accounts  forms  used  m ••■■■-■ 1319 

cemetery  record,  supervision  of 1324 

cemetery  to  be  kept  in  good  order - 1224,1283 

changes  in  buildings  and  grounds 3662 

Chelsea,  Mass.,  sale  of  land  of ■••■■ 1441-1470 

chief  nurse-s,  duties  of 3011 

^                                                                     1 901 

civilians  in ^'^°'- 

cleanliness  of,  responsibility  for 1371 

clerical  work  supervised  by  pharmacist ■■■■• 1372 

system  of ' ^"^^ 


closing  of 


1316 


ciosuigoi 

commissary  department,  under  pharmacist ■.'.''.'.'.'.'.'.'.'.'. 1319,1411-1418 

ledger ^* 

construction,  disbursements  for 

convalescents—  1313,1507 

detailed  for  work 1230 

discharged  when  flt  for  duty "' 1266,1286 

returned  to  duty  promptly 

correspondence—  1262,1389 

how  conducted 13(  1 

supervised  by  pharmacist 1353 

^  1 CC1 

day  ofl  duty ^^^^ 

diet  kitchen,  regulations  for _ 1233 

diet  Ust,  special,  revised  daily ■■•• 1232 

diet  tables,  variations  in 

discharge-s- .  j236 

for  disability i''^" 

on  medical  survey ; ■  - • ; ■'  1365 

discharge  of  patients,  regulations  relatmg  to - 1281,1285 

discipline  of, responsibility  for ; •• 1316 

disinfecting  plant,  care  of ; 1316 

disinfection  of  clothing _  15^1 

dispensarv,  regulations  tor 1328 

divme  services  to  be  arranged  for 

4  1^ 

dutiesof— *_ 

chief  pharmacist 1471-14-i 

hospital  apprentices 2581-25S4 

medical  officer ■■■■■■ I'lSl 

night  apprentices "■" ^^'^ 

pharmacist ■.■'.■■■", ^^^^ 

economical  management,  responsibihty  for ;■.;".■.■...... ^^^^ 

emergency  requisitions  from 


350  INDEX. 

Hospltal-s,  naval— Continued.                                                                                                Paragraph. 
employees- 
admitted  as  patients ., 2174 

leave  of 1541 

physical  examination  of 2128 

supervision  of , . .  ^ 1542 

treated  in -.■■■trr 1241,1276 

Tinder  compensations  act 15,}3 

enlistments  expiring  in i-?  <.r 3001 

erection  of .^^.^„^-^.  VXS, 

establishment  of .' ,  ^ 1201-1209 

estimate  of  funds .............  4131 

examination  of  female  candidates  at 210J! 

executive  surgeon,  duties  of 1301-1334 

expenditures 1387 

expenses — 

appropriations  charged  against 3400 

charged  against  naval  hospital  fund 3399 

of  transportation  of  sick  to 2944, 3010 

extensions  authorized  by  Congi-ess 3612,3659 

filing  requisitions  at .^ ,,;^iwi. 1386 

financial  dealings  with  patients  prohibited jjii,pV-\ . ^>. ...  f . , ^ 1260 

fire  apparatus — 

care  of ...'.'.".'.'..'..'.".'.".'.".'. 1321 

bill  to  be  posted '. .'.".".  ...V.V.^ ...  „-Vu- 1321 

drills  to  be  held  weekly ...^j^,,^,.^,,.,/.^;:^,:,"..".;/.. 12S9 

preparation  for ...,,;.,..^.., „.'.,. 1345,1369 

funeral  services  arranged i .'.......'...!. 1323 

headstones  for  immarked  graves..  ..V.V.'V.'.V.V.'.'.V. . . .,,  YtT^p;^^,,^ .1^ 1292 

health  records — 

accompany  patient  to 2229 

examination  of 1226, 222,S 

inspected  by  commanding  officer '..'..'.... 1286 

of  persons  sm'veyed ..'.'.....'. 1237 

submitted  to  commanding  officer 1343 

to  accompany  patient ....'....'.'..'.'.'.".'...:.'. .,'„-'v- .li>^-V-- •  -j" 1229 

chief  pharmacist's  mate  of  day,  duties  of .......'.'.....  i. '.. 1131-1435 

hospital  ticket  to  accompany  patient '.'.\V. 1229 

information  slip.  Nurse  Corps 4131 

insane  patients,  care  of 1316 

inspcction-s — 

by  chief  nurse 1443 

by  commander  in  chief 1251, 2512 

by  executive  surgeon 1308 

by  fleet  surgeon 1136,1252 

by  mcdieil  officer  in  command,  weekly 12S5 

by  night  apprentice HSl 

by  oflicer  of  the  day 1361 

of  medicines  and  supplies 1225, 12Jtl 

of  provisions 2582 

recorded  in  journal 1284, 1362 

instruction-s— 

of  Hospital  Corps 1371,1375 

regarding  transfer  to ...■.■...■.".■.■.■.■.".■.■.■.  2981-3011 

inventory,  suiK^rvision  of ..".'.."...'.  1319 

isolation  ward-s,  care  of 1316 

journal  to  be  kept ..".'..■..■.....  1253,1362 

junior  medical  officer,  duties  of 1341-1353 

keyboard  and  care  of  keys 1322 


INDEX.  351 

Hospital-s,  naval— Continued.  Paragraph. 

kitchen,  care  of 1318 

kitchen,  patients  detailed  for  work  in 1313 

laboratory,  care  of .,j,j,tj„„.j, 1317,1351 

laboratory  work,  report  of 1351 

Las  Animas,  court-martial  prisoners  not  sent  to 12(57 

laundry,  linen  laimdered  in 752 

laws  relating  to 1201-1209 

liberty- 
books 1311 

list 1344,136s 

library,  care  of 1327 

linen  room,  regulations  for 1571 

list  of  patients 1256 

maintenance  of 75 

management  of 1201-1209 

master  at  arms—  j, 

duties  of ,..,,f,wj.j...v> 1431-1435 

visits  brigs ; '. 1368 

meals,  inspected  on  table 1325, 1362 

medical  officer- 
accompanies  patient  to 2981 

always  present -^ i. 1294 

in  charge  of  wards 1228 

in  command,  duties  of 1281-1295 

in  command,  responsibility  of 1223 

of  the  day,  duties  of 1227 

medical  survey — 

not  required  for  transfer  to 2925 

of  officer  in 2913 

of  patients  after  three  months  in 1265, 1286, 2948 

medicines— 

issued  to  persons  not  in  Navy 1255 

to  be  inspected 1225 

mess  attendants , 1318 

militia,  officers  and  men  in 1268 

money  of  patients  to  be  safeguarded ,. 1330 

naval  auxiliary  service,  personnel  in 3011 

night  reports 1364 

miscellaneous  expense  requisitions 3382 

nurses- 
duties  of ...,.,.,..^ 1441-1470 

quarters  of 751 

officers — 

discharged  to  Naval  Home 1221 

discharge  to  be  reported 1221 

entitled  to  remain  in 1221, 1222 

having  special  duties 1341-1353 

officer  of  the  day- 
detail  of ..'.'..'.'.".."...".'....'.'.'.'.'.'.'. 1333, 1334, 1353 

duties  of 1361-1369 

operating  room,  care  of ' 1315, 1350 

order  book  kept  by  ward  olTicer 1342 

orders  to  be  posted  on  bulletin  board 1329 

patients — 

detailed  for  work 1313, 1507 

fit  for  duty ...."....."......'...'......... ".....V.'.V/ 1346 

left  in,  on  sailing  of  ship .j, 1236 

required  to  wear  uniform .,,>,,^y  ..,^i. ;_,„.,.. ^ 1516 


852  INDEX. 

Hospltal-s,  naval— Continued.  Paragraph. 

pationts — 

restricted  to - 1'166 

surveyed  after  three  months  in 1205, 1286, 2948 

pay  of  enlisted  men  in 1213, 1216 

pass  book 131 1 

passes  for  men  and  employees ■  •  • 1311 

pensions  of  men  in 1207, 3608, 3623, 37.52, 3793, 3801-3806 

pensioners  in,  instructions  regarding 1531-1535 

permLssion  to  leave  premises 1310 

pharmacist— 

as  officer  of  the  day 1294, 1333 

duties  of 1371-1425 

Philadelphia,  patients  report  to  governor  of  Naval  Home 1214 

physical  examination  of  all  patients 1367 

prescription  book 1255 

priced  invoice  from 3952 

probationary  service,  time  spent  in 1264 

procedure  on  receipt  of  patient 1234 

property- 
accountability 1257 

accounting 1374 

book,  kept  by  ward  officer 1342, 1346 

responsibility,  special  wards 1349 

psychopathic  wards,  care  of 1316 

punishment  for  offences 1285 

purchase  of 1205 

ration,  deduction  from  pay  of  persons  in - 3622 

records  kept  with  neatness  and  accuracy ..::::::.'\'. . . ; . . ...'.. l.i 1264 

recreation  time  to  be  provided -  —  ■•  • — ' 1327 

Red  Cross  service  at 4352 

regulations  for  government  of 1239,1282 

reports — 

and  returns  from 4131 

concerning  Hospital  Corps 1288 

of  admission  of  officer 4131 

of  condition  of  patients 1284 

of  discharge  of  officer •  • 4131 

of  inspection •  -  -  • 4111 

of  laboratory  work 1351 

of  officers  transferred  and  discharged 1221 

of  public  works 1 291 

of  sick,  morning 1348 

of  sick,  weekly 1238 

of  work  done 1349 

statistical,  compiling  of 1256 

requLsitions — 

for  supplies 1385, 3531, 3541 

sujiervLsed  by  executive  surgeon 1314 

responsibility- 

for  cleanliness  of t 2581 

of  medical  officer  In  command .'." 1223 

returns  supervised  by  executive  surgeon 1314 

routine — 

sick  officers' 1*^1 

wards 1*^0 

rules,  for  patients lSOl-1528 

--Wmitary  report .'..  1259. 2584, 2635, 2ti51 

'  'iwvlce  performed  by  HospiUl  Corps 402, 435, 1261 


IIs^DEX.  853 

Hospltal-s,  naval— Continued .  Paragraph. 

service  to  patients  by  attendants  only 1 231 

sick  call 1348,1368 

sick  officer's  routine 1491 

sick  removed  to,  when  recommended ; — 1211 

sites  authorized  by  Congress ■■ : 1209, 3G12, 3659 

'  ■ .   special  diet  list ...;...;;;:;... '3961 

(:'  revised  daily ■-^. .;........•.:. : 1233 

^'    special  diet  sheets  inspected ..;...: 1325 

V     special  forms  used  in .».>.  =  =  »  a  =  i 4001, 4002 

>"•    special  requisitions  from - ^  -  ;iJP?«>3i>  liii 4131 

?     statement  of  cost  of  maintenanc* ^ 1^21-^1425, 4131 

;;    stores, record  of -. -- ViiiJJU<l:i-L....:......2:..    1390 

;:  ,  subsistence  of  c  ivU  employees  in ., .-.-..,i:i  ;.'<>.  >  JeJiQ?0/l .,.'.'-  ;•. . .  S27S,'8ei4^'3657 

r.   Sunday  observance :siiiiirjiLle7iiii^:itiV<liiuii!liJS?jl.'l<Xl>?P.t!i  c  ."■'...'.TilCC-.  :'iM285 

b:  superintendence  of .." -...-.Iv.^i-'.U  j>inJ  l|i30li'3010 

fi    supernumeraries  in,  instructions  regarding Si' jr.fu.'^cri  Ji'm.  11531^1535 

<;     supplies  to  be  inspected .rc/.ijj.."  .^1225 

surgical  operations,  necessity  for -  -  - -' i .'. . .    1287 

surgical  wards,  supervision  of - :...[;:...    1350 

surveys  on  materials,  held  when  necessary -  —    2968 

traasfer  papers 1215 

transfer  to --- 822-824,1143,1211-1217,3001-3011 

:•    treatment  of  civil  employees  in - - . .    1241 

tuberculosis  cases 1212 

,:    uniform— 

of  Hospital  Corps  inspected 1329 

prescribed  by  executive  surgeon - .  -i^' .  -  -»w  .<. 1304 

regulations  to  be  observed :t  J-i .iJ.?v 1290 

service  to  be  worn : .i. .j. . . . . ,  1332 

valuables  of  patients  to  be  safeguarded •  -.- . . .  ^^  - .  1 1330 

visiting  hours  to  be  designated - -.^-.-w-.-.-;- -  ■    1331 

;  -   vouchers • •-- — -.^-...-.-  -.-.- 1386 

'     wards-s—  • '  ■ 

forms,  kept  by  ward  officer 1342 

nurse.    (See  Nurse,  ward.) 

officer,  duties  of —  '*  r.^.d-^^-i-hi^'yaTjiiT  1341-1353 

special  property,  responsibility -.-.- -a. > ,vfH-*9w»^ Si -. 1349 

surgical,  supervision  of -  •-  - •  - •- .•••:--■    1350 

X-ray  rooms,  regulations  for 1561 

Hospitals,  other  than  United  States  Naval,  patients  transferred  to 2985, 3003, 4111, 4121, 4131 

Hospital,  reserve,  base  hospital  acts  as 1^69 

Hospital,  Sanitarium  Co.,  Portland,  Oreg 3164 

Hospital.    (See  St.  Elizabeths.) 
Hospital  sbip-s: 

accounts -  -  - -  ■  •--.-.-.•.••<»* r,j  -  -r  •  -    1726 

of  master -  -.-  -  -  -.-  -  -.-  ^  •Ki>-i-. 'eitfr 1"26 

on  designated  vessels 1724 

adioimstration  controlled  by  bureau 1"01 

aid  societies,  regulations  for -  -  --.-.-.-.-■  ■:;  -r.- 1 1  '•--•-•,-•-  -    ,^223 

appointments  governed  by  Regulations  for  Naval  Auxiliary  ServiQe..........-.-.-.-.-.-.-.-.-.-.--rh>'^,-.trs^rr;(iil727 

assimilated  to  hospital  on  shore — .-y:!«?k-ip«w-yJ.'x«;-f-i(C-«s? -cvr-fi.,-^  J705 

authority  of  commanding  officer ...-......-.-.-.-.-.-.-.-  -.-I^<)jf  fw-»<£ffe  it\-  ■■  612, 1022 

authority  of  master -.-  -'4  Ji-iU-o.^pjy^  iv>iJM;Br.*.-;,^v-yi J716 

boat  instructions 1-22 

capture  of —  —  ■ • •'219 

chief  engineer- 
duties  of 1718,1740 

responsibility  of - 1718 

98601°— 17 23 


354  INDEX. 

Hospital,  sliip-s — Continued.  '.^.>..   l  '.n-tii.  ,<■•» 

oiAilian  complemtnt—  Parajniapb. 

classification  of ,.,.,,., 1715 

regulations  for ,,,.,,.,,.,, - 1728 

classed  as  naval  auxiliary ,...,,., 1  <  06 

cognizance  of '' • -■?--»i •■.- - -< ^ ' f 2 

commandini;  officer  of - l'^" 

command,  succession  to... ^''0 

conventions  governing Mi-v.-j* 1 1^04 

deck  officer,  duties  of ••  ■ ^  '^9 

deportment  to  be  civil  and  decorous ^-  - »: 1730 

designation  of i. .  i ..... .  — 1702 

,      design,  approved  by  bureau. , -. • •'"- -I'i '•*' ■  .>i»ii"-1701 

details  and  duties,  Hospital  Corps. -i  -"-'i-^  olqaa. L.ii.i  Ic.-. -J.  I'.ir    425 

discharges  governed  by  Regulations  for  Naval  Auxiliary. Service o:;-:. 1727 

discipline  aljoard • -^'■''- '^^ 

distinguishing  marks -,aiiia^ti..i.ii.vJtiLjj.d,..- 4303,4306 


_f.c 1702 

chief  engineer 


duties  of 

:(.ly.iir.-.: 1718 


deck  officer '*- ^'^'^ 

first  officer v,tu...aa.^. 1717,1738 

master -..,im,  1737, 2586 

medical  officers.. .:.... •■• -'•■-  2581-2580 

exemption  from  dues  and  taxes — •-•v— ~ -''^'-  '^"^>'J^^- 4291-4297 

^?T'7!  ...■.■.".■.■.■.■.■.■.■;.■.■.". 1717-1738 

duties  of ^  _ 

responsibility  of - •-■■ '_  ' 

harbor  regulations  observed  by - .x'.  .U; 2585 

improper  conduct  forbidden --  - ^'-  ''^^>^^'- -  ^'^- 

inspection  by  commander  in  chief - I'OO.  2512 

instructions— 

governing • ^'_^ 

signaling ■ ■  •  •  • "  ■  ■ ;  • ^'_^ 

use  of  boats • ; '  . 

;......:'.'.'.'.,... *:;.l 1.2o 

issueson 2^^^ 

journal  kept  by 

Junior  medical  officers  of - - ■ •  •    J'J' 

liquor,  intoxicating,  prohibited '  - ■'■.'■."'^•'" "    \J^ 

,        ,  ^ .i..!.::'...    179q 

log  of 

manned  by—  • 

Hospital  Corps aiiV-': |J^ 

merchant  crow 

masler —  .-^ 

^^'^^'f<>^- :::::::::::':::':;mc,i742 

^"^^°"7°^ ■   : 1716,1737,2.^86 

'^"^«^^«V.;;. ••■• 1743 

rcspoasimliiy -. ',      '  '  1741 

medical  officer  in  command,  reports  from....... ....,-..■.:'. ^..    i^«» 

messes,  arrangement  of .......»-..,.^ v-^-Mi'i.i ^^^^ 

^ '  'obedience  to  authority  required —• — '^ 

officer  on  duty  in  port -• - — '" 

orders  for  organUHt  ion  controlled  by  bureau ^'"''^^"t^iJ,"/o^  t'ln- 

pmntingtol>ocl>uractorislic • ...I.  1707,4222, 430o 

p(irsons  traasported  by ■^r-r-^-r-T-'-^-. - "    ^^^^ 

position  reported  by  nulio ■  •  •    ^_^^ 

(juartcrmaater  on  duty  in  porl - - '  ^ 

Red  Oroas  organiiation  on — 


IXDEX.  355 

Hospital,  ship-s— Continued.  ■  "^ 

reports-  Paragraph. 

and  rctitms  from -'^-  - 

Of  inspection  of : .  ....ftooji  ^  aafisci    41U ; 

regulations- 
civilian  crew 

governing '•-'. '■ 

<"         refuse ^■-- .......  =  >.........  =  =  -.  =  .-  =  .> -■ 


1728 
170  J 
1735 


reports-  " 

Si '       medical  officer  in  command - •••' "^^ 

oi         swk,  weekly ■■ ^ -  -  ■  • ■-  •  — ■  •  ■  - 


•-'  re-sponsibility — 

^ '         for  cleanliness  of 

Vl'      -of  chief  engineer ........1....;;.....  =  —  ^■■■' 

J'i^^sr'- of  flrst  officer =  ..^...........w.."---' Ji-.i.c-m? 


2581 
1718 


services  as  base  hospital . 


■U/1-;  iV.'i  Aiyi:;:';V  w :. . .     1849 


..., .....V.....     1727 

172S^ 

.  =  ..  =  =  ....."'- .1733 

lymX^OTl  9v.'. ■:-'■  1802 

.'.QitifwxaPJiV.'J. 1713 


shipments  governed  by  Regulations  for  Naval  Auxiliary  Service 

signals  used 

smoking  rules •  - 

transportation  of  wounded  by •  - 

'■'-   traffic  by,  forbidden 

uniforms— 

governed  by  Regulations  for  Naval  .\uxiliary  Service .......:.  iLOi'.^iy.a .  * --. 1 ' 2i 

to  be  worn "^ .:.....:  w..  =  =  ...-:r':?7?C.>..-    1731 

'  C'"'  '     "  1802' 

wounded  cared  for  by ;  -;  "."'■■/'■■ " ' 

woimded  transported  to ; -  -  - ^  -  -  - .  -  -  - .  • 

Hospital  staff  of  captured  vessel,  neutrality  of •  ^ .........:  4217, 4218, 4278, 4310 

Hospitals,  State  of  California,  for  insane..... -.-.-.-.-.-.- ypJ .-  2289,2439,3152,3156^158,3160-316* 

Hospital  supplies,  provision  of,  in  field ..-.-.-.-".-".- .-..-^ ■ ; ' " ' 

Hospital  ticket-s:  0009 

accompanies  patient  to  hospital ^°^ 

■     disposalof ■ ■--'■ 1365,1002 

-     FormG - ^ ...3922,3937,4121,4131 

to  accompany  patient .........-.; -  ■  = 

Hospital  treatment: 

of  applicants  for  enlistment ^*^^ 

1917    I'^Q'i 

when  no  naval  hospital - - .....^^^  =  . ini,i.o^o 

Hot  Springs,  Army  and  Navy  Hospital................ .......iP.  nj...to: 1591-1622 

Humidity,  excessive,  exposure  to  be  avoided 2621 

Hydrocele: 

entered  on  report  of  rejection...^.... ■ -•--•- ■ f"°* 

t^jectionfor -- • .......:......:..:.^::^a^-.t-:  1961,1981,2071,2079 

=yeie°e=  1375  2575 

instruction  in ■- ;.....^:^^.^ a^ 

naval,  department  of .......:..;.....;•...:.....- 

2591 
supervision  of,  at  stations -  —  ;..:..-...-.--..-.---•  = 

Hygienic  regtdatlons  of  ships ■  ■  ■ ^ 

Hypochlorite  of  calcium,  purification  of  water  by. .... : .; ^    26-1 

Hypospadias,  rejection  for... ....-........; ; -- ■■■■■■ 20/2,20/9 

Ice,  entry  in  bill  book -■ ■■■■■^ 1395 

appropriation  for  purchase  in  hospitals ■■■■■:~V,:"\"r'"';""    ^ 

Identification:  J   1"  ^  \' 

of  dead ■■ .........^^^^^■ft^9l^i71<n.im,mr, 

record,  preparation  of ■-"•-■,■-•*•■■■"  2093-2096 

tags,  personnel  to  have i:P3..... ..1851,2097 

Identity,  certificate  of,  for  armed  escort  of  ambulance  party .::  •.-..•..-.■.•.•.•.-.-.■.-.  i  -.  -. -  -  •    1845 

_,  ...  .1'  J  aji  vnh3fe->  e-tfT^bt'v  '  .",    -'r''; 

Illness: 

coniidential,  of  nurse ^^'oftq 

extension  of  leave  for 


35B  INDEX. 

lUness— Continued.  Paragraph; 

former,  entered  on  Form  X  (rough) 207S 

nurses 7U-717, 1440 

Incontinence  of  urine,  rejection  for ?072, 2073 

Indorsement-s,  court-martial  records 829 

Infected  ports: 

hoaJth  of,  to  be  ascertained , , , i-'007 

to  be  avoided 2006 

Infections  diseases: 

care  of >  j,  -.-_-  t-^  -      812 

men  with,  not  to  be  traasfcrrecl ;»**'■  ,/w-    21W 

patients  not  to  be  in  landing  force ; - 1844 

precautions  regarding 0J6,36(Hh2a»>,2»l4-2C17 

prevention  of , . . , - - .  ^  — ,,,,,,.......,,... <«ar,^.i - •. 812 

report  of ,...,. ,,...,,,,,.,,py>5;K........  812,828 

by  commander  in  chief ..,.....,, .....,,.,..,,,,...,...  .if.H'f'ni ■>•*«.* '  —  2513,2501 

treatment  of , , , ^.»jivsi»»*>  T>.x»rijiuM -i*rv*X-  -•v>»-.--«ni>bk»i«)>{-  «ij(-festFi 812 

Infirmity: 

applicant  rejected  for ,......,.,. 2079 

mental,  certified  to  be  free  from , i.>{,ffi^>^.V. 2081 

Inflammability  of  clothing  reduced -.r. 1S25 

Inflammable : 

liquids  during  fire  drill .^ . . ... .....  .>;.-.•; .....  .^. . .  -;. 983 

stores,  care  of ...,...,,,,,,,..,,.,,,,..,,,.;..........;.. 903 

Information: 

bureau  division ■ ....... .^-i 4355 

slips.  Nurse  Corps n-  -Uw.'^f  i •*13l 

Ingrninal  rings,  relaxation  of,  not  cause  for  rejection —  .j..f,^i>ia»oii'>:-''-'^--- •   <P^k 

Inhabitants,  aid  to  wounded  by , . ,t,^,tt.ft<. i™^.,.; .j.*., h, ....,_.,...,  -^^v^^^ 

Injured  civil  employee-s:  ■   ..  > 

affidavit  upon , -  -  ■  •  r  -  -.  <8ti>  ji!i*H-s»  -ift^i- 2104 

ambulance  service  for 1240 

at  navy  yards ^y. „,,,.■  917 

compensation  for f  r<7- ••r-v .-.»;«».  -^,931 

report  of 2171. 

Injury: 

classification  of  causes  of 2335 

compensation  for,  authorization  of 2124, 2101 

death  from,  report  of ,,..,...,......,...  2103,2176 

eyes 210* 

eyes,  prevention  of ^f,,. ,:,,.., ..„,,,. 2120 

former,  entered  in  health  record 2241 

key  letter  for 23iSn23a8 

nomenclature  of ,..,,........,._.;. 2321-2361 

noted  on  health  record ^.^j.^ 2209 

officer  to  report '.'....'...'.'.'. 3352, 3363 

origin  of— 

decisions  regarding , 2h21-2S37 

to  be  stated ^^^  .,^ „ ,  v-m.-fr  •» 82« 

serious,  entered  on  Form  X  (rough) :•••••• -'.,.■-  j. 207U 

Inoculation,  protective : 

entry  in  Form  K 238Q 

landing;  force  to  have 1S*44 

Inquest: 

board  of.    (,Sc(  lioard.) 

entered  in  journal 2318 

Inquiry,  court  of,  on  accidents  causing  death 212G 


Insane. 


INDEX.  357 

Paragraph! 

3101-3166 

admission  to  St.  Elizabeths  Hospital  for  Insane •  3121-3123, 3137 

applicants  for  enlistment,  detection  of 2063 

pare  of 1316,3124-31-31,3133,3154,3164 

charge  for  transportation  of '3 

clothing  for • • ^^55 

death  of. ■• -MCUi-iwJji;  3136,3157,3162 

discharge  of - 3W5,3166 

enlistment  of,  prohibited 2001, 2014,3112 

expenses  of  care  of -- ^^^^ 

Government  Hospital  for.    (See  Hospital.) 

.-.    health  records  of 2289 

in  Alaska -  ■ -  •    ^^''^ 

medical  history  to  be  obtained 3127,3130 

menace  to  community • 3165 

on  Pacific  coast,  care  of 3141-3166 

papers  required  for  admission 3137 

payment  for  care  of - 3158, 3159 

receipt  for  persons  and  effects  of ■ — 3134, 3160 

recovery  of,  procedure '■■■"■' 3132 

report  of  condition  of 3131, 3153 

State  hospitals  of  California,  for -  -  -  j  -  -f-'J 3141, 3166 

survey  of 3124, 3128, 3129, 3165 

transfer  of - 3125-3127 

transportation  of .~-.^-. ... — 3133, 3156 

Insanitary  articles,  survey  of .K.xjA.i-.  i 'jvj.-:li  JA''...  A  .v...',.. .  yrJi??J:. 2537 

Insanity,  rejection  for ^■^..<^^.ii..~ - .■.■.-.■.■..■.■.■.■:: . . .    20/9 

Insecticides ■.j'J'Ji^UM :^ii.vDJjV: . . .    2781 

Inspection-s : 

board  of,  for  ships 891 

bumboats 2571 

camps 2621 

colls - 854,2572 

clothing  by  division  officer 254$ 

entered  in  journal 2318- 

food  for — 

ships 820 

sick : 2565 

health  records— 

by  oommanding  officer 2224 

by  fleet  surgeon -  -  •  - 2219 

holds 855 

hospital-s — 

by  chief  nurse 14^ 

by  commander  in  chief. ......-.....:  — .  —  12.51,2512 

by  executive  surgeon 1308 

by  fleet  surgeon • •  1^36, 1252 

by  night  apprentice -'■ 1481 

by  officer  of  the  day - - 1361 

report  of 4111 

ship,  by  commander  in  chief 1709, 2512 

ships,  report  of 4111 

weekly '  -  -  - ^'-85 

journal,  by  commanding  officer -  -  - ; 2312 

liberty  party - 1504 

living  spaces 856 


358  INDEX. 

Iaspectio&-s — Continued.  Paragraph. 

meals  at  hospitals .-. .  ..•.-.■.-.•.-.•.■.•.-.•.•.-.-.-.•.■.•.•.•.•..■.■.•.-.•.■.•.•.■.-.-.•.. .  1325, 13fti 

medical  department A'Jv'Jli,  Ji^LlA'-J'Jji'iLi'.iJf'Jml'dA-:-..  ':S\: 891 

by  fleet  surgeon -.•.■.-. .■.-.-.-.-.-.■Jt'.aw i.'^^b.^MV.tUl':. 1132, 1162 

of  ship,  report  of ..-.......■.-.-.•.-...•.•.-.  .-.-.-...•.v.-.-.-.-.-.  .-..•.-. . .  4111 

medical  supplies ....  ;....-...-...•.■.  .-...•..^,K'iJ'JlU;U.'.; .. ...  W4, 1225, 1284 

medicines,  entered  in  journal . ..  .•.....-.•.•.■.•.•.•.•.■.-.•.•.•.•...•.-.-.•..-....%-.•.  .:.•..'. : . .  /''  2313 

not  to  be  held  oh  Sunday .^...^..-.^■. ...... ^^-.^^v^^v^v...-.-...-.-..  v.' ..t.!'   1285 

prisoners -...-...,...-...-. — .....^.■.^.......^.■...  .\  ::>::.  8»i}iS72 

provisions—  — ^■-  ,.i  '■    '■  i  i'   ■• 

entered  in  journal.. ~,..,^^..^..^,^..,..,..  .,-...-...^.... 1362 

for  crew J-Iulll  ."jH  »'ii.\ SW, 2.568, 2570 

("L\      in  hospitals — > »^^v.»..-i'.;  j'j:.^.. —    2582 

t  ■ :  .^juarantine,  vessels  of  Navy  subject  to , .^.  v . .  i\i 2732 

sanitary— 

by  fleet  surgeon 1133 

of  ships,  report  of 4111 

ship,  by  fleet  surgeon M<i:i'iai...   1113 

special  diet  sheets 1325 

storerooms - - :....'.... ss.") 

stores,  entered  in  journal., . ., - - 1362 

supplies  purchased 3330 

weekly,  medical  officer  accompanies lo'i  .wojol. 2.573 

lastruction:  

ambulance  party  in  first-aid .  J:i.. 1804 

of  band 1822 

by  correspondence.    (Sec  Naval  Medical  School.) 

first-aid - 4.56,818,849,909,1001-1012,1804,1810,1813,1814,1821 

Hospital  Corps 424, 455, 910, 1288, 1371,1375,1447, 1814,1821,2575 

hygiene 2575 

. ,    laboratory  technique - 1 .. ... .  J 1351 

Naval  Medical  School. , o211-3220 

Nurse  Corps , 611 

personnel  during  general  quarters 1823 

signaling 1723 

use  of  boats. 1722 

Instrument-s: 

care  of .-..^-.-..j..;  -..,...........■.■,  •....,^v..y......-,^*.-,^^^."^.-^^.-vv.—^-,- .-  ■,.■-  ■ 1350 

selection  of - . . ..  -  - - ... ....     3329,3533 

sterilization  after  bal  tie 1828 

surgical- 
appropriation  for 131)8 

responsDjilily  for ,,,,,,.,,„,.„ 39(i6 

survey  of 862 

Insular  possessions,  natives  are  supernumeraries , ►iu. ;..... 2247 

Intellect,  deranged,  reject  ion  for j  .■..  t  J .....-., .  ISWI ,  1981 ,  ;}079 

Intelligence: 

determined  on  enlistment Jtt;6,200.' 

OHice  of  Naval,  report  to , ...... . . ........ ., » Jijflti, 26^5, 2661 

recruits,  cstimal ion  of ...,,,, .,,,^,...,,..,„,.,,,.^, i*.; . ^ 946 

Intemperance,  c\  idence  of,  rejection  for 1961, 207!) 

Intemperate  habits,  evidence  of :....,.  avi .t.  jrji 206;* 

Interest  on  Navy  ponsion  fund u i  j 3704,3780 

Interments,  >',\i)eii.s<sof, how  govcrne<l .i(i..  34(Vi,3453 

International  clasfllflcatlon  of  diseases  and  injurfos v.!.ij.4ii.aii.;.c-.7.' 2358 

Internments,  bclHiiercntsuotined  of ■•2;i6 

Intestinal  parasites,  njeolionfor , 19M 


INDEX. 


359 


Intoxicants:  .!-.iim}£toO-J.i  Paragraph. 

entry  mdioaiiug  use  of 221,8,2812,2825 

forbidden  on  hospital  ships '  — . .  ^^ .  ,.-v 


report  of  use  of 

Intoxicated,  enlistment  of,  prohibited  — 
Invalided  from  service: 

abbreviation  for 

procedure 

Inventory: 

hospital,  supervision  of 

kept  by  chief  nurse 

of  articles  for  sale .' • 

of  effects  of  deceased 

of  property,  Forms  J)  and  Da 

quarterly,  of  commissary  stores 

Investment  of  Navy  pension  fund 

Invoices: 


;., 901 

u  i{ub.iv^wi200i,2014,2063 
.  id  bsiat'io  &j  ioqfct 
.eras:! 


l^£=•^Aci■^-•2284 
2284 


1319 

_...,v:wX;  am  t ^  -'•  -  ■    1445 

^.,.^-\Ciif. ic... ..... .  2955,2975 

. . . .  i  Ailiii  **iJJi^iX9JljL 2414 

... . ........ . .  3922, 393&,p4121, 4131 

.  ,4mavii.'a.-i'Jt''.!JS'JX^-/ti»&ii!(i*J'''e:*i... .-     1413 

.  .^.jwti»?fK4i.iiV':iib-s'j'itws'it^.'^''v-i"-''^*/3703,3781 


3517 


,,,.. e-aoiv-ivtiaiT: tfo'ki. - .--•«-- -.'•• ,-  3512-3518 

„^.^x^-. -.-.-.-,- .-.-lO-'.'-I^O  rVi-^+V- aL-  -  •   3518 

,  ,Vj  ,t.viHfS?  ,>t-i<>*r-'^?c>-i«^B«tii*t-  -  3511 

„,,,..,.,., Ii,^i.V*'!--f^-'^->i-   858 

.  .1^.^..^....  -.."-\. .....'..'■..  I  bf^M.<^.  -  -  3922, 3931,4121, 4131 

............,;a«4svii*i)-^'-- 1316 


for  medical  outfit 

going  into  commission 

out  of  commission 

instructions  relating  to 

medical  stores 

priced.  Form  B •  -  - 

Isolation  wards,  care  of 

Issue : 

of  stores,  loss  on - .  -  ..-.-jiwv*  leaiv^i. 

method  of •"  ■ " ' ' " ' "  "■■■'■" 

on  hospital  ship •  ■  ■  • •  ■ " " ' 

■"Jeanette,"  date  of  death  of  those  lost  in  wreck  of. ...........  .......-.....■...--.-.•.•--•.-.•.-.-.-.-:•  ......■-,••-■ 

Joints:  ■■ ..-f^jqoH  .r^.d  v.m. 

ineflioiency  of,  rejection  for 

stiff,  entry  on  report  of  rejection 

Journal,  hospital: 

absentees  noted  in —  -  ■■.-.--.-.-.■.-.-.■.■.-.-.■--.--■  ■ ...^  -■......£  ,■,-■-,..-  -  -r ----.-; 

entries  in ..,....,.„.„„„..... .-..-^---■■.He'i=i'>i^Hfit-£-.*wi*r>i 

,     ..  i.        ■  -.;  v,-aiii.c«T.^j .{>->.  1284,1362 

record  of  mspections  in ..--.-.-  ....••.- -.------.-.-.-.-.-.-■•'  .-issr  c.ii  joi  -u 

signed  by  officer  of  the  day -  ---.-. -  •- ••  •-■.■.•.■--••  -.-.-.-.-.-.-.-.■.<?££{• 

submitted  to  commanding  officer 

supervised  by  officer  of  the  day ........--.- .,..-.-..  -  -  -  -  -.-.•.-,-.--■•  ---  -.-.•.-.-.-.---.--.-.■.•  .-.-;8Hm;r:jfHe*nr>  -      ^ 

^_, J^--j^..i>,.,{v  .        l^OO 


1414 
3303 
1725 
3743 


,,M61, 1981,2079 

2081 

1434 
1362 


1362 
1362 


to  keep . 


Journal,  Medical  Department 

autopsies  entered  in 

changes  in  personnel  entered  in . . 

deaths  entered  m 

epidemics  entered  in 

examination  of  water  entered  in. . 

forwarded  to  bureau 

hospital  ship  to  keep 

inquests  entered  in 

Inspections — 

by  commanding  officer 

entered  in 

of  medicines  entered  in 

medical  officer  to  keep 

monthly  entries  in 


■'^•■iH'yAfJfKrrr^-r^  ;864,961,1227 
.;.-.-.e-Htxi«s.-+..ln..-  2318,2443 


-r^iO^e^i^t,- 


...    2318 

2318,2434 

L.....,..,    2318 

:..._„..;jaj^ 

2318, 4121,  ilM. 
'  2316 


. . . . : •. .  4^.,,,^.,. . .  2318, 2443 


2312 

,,. 231S 

^..,,,'...„...  2313 

..".,,.».,.,....  2318 


Nurse  Corps  changes  entered  in ■xtrAWfri-AT/i^)    ^M 

officer  of  the  day  keeps 2^^^ 

receipt  of  stores  entered  in 


360  INDEX. 

Jdamal,  Medical  Department— Contiuued.  Paragraph. 

requisitions  entered  in 2318 

retained  by  ship  or  station 2318 

sanitary—  , 

condition  of  ship  entered  in ':.l'.>.iii90:i 2591 

reports  entered  in ■. .,_ 2318 

ship  to  keep 2316,4121 

vaccinations  entered  in ,. 2318 

Junior  medical  officer-s: 

hospitals—  ■,    .  •  ,  •      ' 

alternate  on  duty 1353 

cleanliness  of  wards ; 1343, 1347 

consultations  with  executive  surgeon 1342, 1350 

duties 1341-1353 

duties  assigned  by  executive  surgeon i3.ll 

executive  surgeon's  directions  obeyed j  342 

executive  surgeon  tosupenirise I3a5 

fire  drill 1345 

inspection  of  fresh  provisions , 2582 

inspection  of  ward  with  executive  surgeon 1347 

'  laboratory,  care  of 1351 

laboratory  work,  report  of 1351 

leaving  hospital 134«,  1353 

liberty  list  prepared  by 1344 

officer  of  the  day,  detail  of .». 133S,  1334, 13S3 

operating  room 13g^ 

opportunity  for  surgical  work 1282 

order  book  kept  by 1347 

patientsfit  for  duty ,it. 134G 

patients  surveyed . .  ^p.tj.  ..•.,;  i". 1346 

property  book  kept  by 1342, 1348 

reports  of  sick ..floioWix'-A'.  rM 1348 

responsibility  of .'..-...■  jj 1347 

sick  call ]  348 

special  diets  supervised  by .1.. 1344 

surgical  ward  supervision ,., .^.. 1350 

ward  forms  kept  by 1342 

hospital  sliip .-.•.•.■.•-■-t.-.w  .■.•.-.- ^^v.-. 1712 

ship —  ■ 

consultations , 883 

duties  of 881-884 

health  records  kept  by i.. 882, 1343, 2206 

inspects  bumboats , 2."71 

inspects  fresh  provisions ....■..' 2570 

leaving  ship SS4 

shore  stations 919 

Kerosene,  use  of  as  insecticide .im..i 27S1 

Key-s:  

board,  hospital  keys  hung  on 1322 

hospital,  care  of Ii22 

kcjit  by  ward  nurse 1402 

loiters,  use  of 2:J25-232R, 233,5-2337, 2385 

Kidney  disease: 

examination  for 1984 

rejection  for 2079 

Killed,  report  of sisi,  1 1:57,  Ini,'.,  1S08,3922,  SMI, 4111 ,4121 

Kin.    (.Hee  Next  of  kin.) 


INDEX.  361 

Kitchen,  diet:  Paragraaii.: 

regulations  for • wa»,;ii.jX>la  «-j1j4;-  . .    1481 

supervision  of , --•  •  v»&  JiiUqroiL  ij'1446, 1450 

Kitchen,  hospital :  . .  .jioi.ai-;'^. 

care  of --- -. --. •■'-' ^^^^ 

,    inspection  of —  -— j«a'. iO j. Ai »-•- . .    13G2 

patients  detailed  to  work  in giJi 1313 

Knives,  Hospital  Corps  to  carry .,„„„„„-„ — Jiliiz  Jla  iii;  ISM 

Knock-knees:  ::'ix'...1 

entered  in  health  record -  - ...........  ^,,  jiood  JJfd.ai  -i .  i. ;;.;.... .    2241 

examination  for ..-  — •tvjl.iiiJJs^im . -■ . 2061,2079 

Laboratory:  ''■'■' 

examinations,  report  of 1162 

hospital,  care  of - ^,. ........ .  1317,1351 

technique,  instruction  in ,iUj^v;ii,iii  Jwnji-iu .1851, 1375 

work,  report  of - ------ "■^^'^ ■^^■- -i-i^i-.^iisi. . .    1351 

Labor  board,  duties  of ■ .-2141-2154 

Labor,  request  for  transfer  of ....-.-..-  -.-..-. .lit^.-jwiwJj ...3994, 4131 

Labor,  Department  of,  blank  forms ......,..,..,..,,. 1 . . . .  2172, 2175 

Laborers:  •  i)t'  Joooil  . 

eligible  list  of - ' 2143 

rating  of oaiiujesy. 2145-2155 

Lading.    (See  Bills  of  lading.)  -     "'"' 

Landing  force: 

boats  for 1853 

duty  of  medical  officers  with 2621 

evacuation  of  wounded .•- - ,..,^1^^.  .i.ii.ii... ..    1869 

expeditionary  service ---- ----  1841-1869 

organization  of  medical  department  for ..i- 1841 

Las  Animas  (now  "Fort  Lyon")  hospital,  court-martial  prisoners  not  .sent  to 1267 

Latrines,  precautions  concerning --„-.,,..,„„ 2621 

Laundry:  fwi!: 

hospital,  linen  laundered  in -  - — -  Ji  - .,..:-.  -"J  -•.■;•-  •■     752 

ship's  medical  department — ■-  -'■-■A-  ;-----•  J*  -<j'*ii -  J v:>!  '  861 

Laws,  military.  Red  Cross  subject  to -■.■.;■  43^ 

Lead  poisoning,  prevention  of ..-  —  — .,,.,.  j.....^-Jii;., i.... v.. j.Au.L'iv.' 2618 

Leather,  disinfection  of — ,.......,,,„, -j: 2769 

Leave,  sick:  jiqaori  biBi 

board  of  survey  required -.-. 2909 

health  record  forwarded  to  bureau ....■.^'...■j..h:!....m... .— 2266 

pension  status  when  on S.....J... ....;...    3729 

Leave  of  absence.    {See  Absence,  leave  of.) 

Leaving  ship,  permission  required -  -  -  - *^S4 

Ledger,  commissary.     {See  Commissary  ledger.) 

Leg,  first-aid  care  of  wounds  of - - lOH 

Leprosy,  quarantine  for -i ■■■■    2731 

Letter  of  application.  Naval  Reserve  Force : - .  -  ..,,„,,,„„, ,,,^viiqiv>.-<j>132 

Liability,  United  States  not  exempt  from '- -  -  .:.-.".fiL*.-!.'<>.f.'^j.'.f.'vf.  !\ji .    2167 

Liberty: 

book,  hospital  to  keep 1311 

condition  when  returning  from -  -  -  r -  -  -    1504 

dependent  on  local  sanitary  conditions —  ■  -  i :i 2535 

inspection  before  going  on .........,,,,,  ^ ,,,,.,, , 1504 

list,  preparation  of -.-.-.--.-.-.--.-.-.-.-.-.-.-.-r^.-,,,----  1314,1366,1467,1503 

patients  with  venereal  diseases  not  allowed  on ,.Hv>(,.T-iij'«si-)ii.i4WrfeiHii-<fi!(*t-»  -  -  ■--■-- 1505 

restriction  or  deprivation  of ,..,.......,...,...  ...«& wij«rio^s?3s •£■  rioif*  -i'M  ■--'  1 2517, 2543; 

Library,  Naval  Medical  School,  regulations  for ...,..........,,,.,,...,, , ...:j--<.pei hwffi'.'y .^a'i. " -.- >  3220 


362  INDEX. 

Ijght-s:  Paragraph. 

allowances  of,  Nurse  Corpb ■ ■. . .  .■.-.■.•.•.■.  .•.■.-..■.•.•.■.•.■.-.•.-. ::. 751 

lurigade  hospital  designated  by . . ... . . . ...  .-..•.•.•.  .-.■..•.-...•.. . .-. 186)> 

dressing  station •.'.•-'. '. . ':':}  1824, 1865 

duty  list .....^.^^.......^..^:  ::::..      1467 

for  comfort  of  crew ..-..•.•.... 2539 

reading ...•.-..•,,-,•.-..-...•..'; 26-10 

lighting  of  ship .......-,.•... ...... . . .  ."'.V 2542 

limbs : 

artiflcial,  entry  in  bill  book .-. . . .-. .-.-J V.  :iV.  'J.V. 1398, 1402 

iuetriciency  of,  rejection  for .'. . . .  1961, 2079, 214» 

lime,  disinfection  by 275:? 

linen: 

nurses'  quarters- 
laundered  in  hospital  laundry 75i; 

supplied  by  Bureau  of  Medicine  and  Surgery. . . .  ..•..-.•.•.-..•.•.•.•.-.-.•.■.•.-.•.■. 752 

room —  •  •  ■ • 

regulation  for .■.>.>...-..:.■-»■-•.- 1571 

supervision  of ....•.•.•...•.■.. 1445, 1450 

line  of  duty.    (See  Not  line  of  duty): 

adjudication  of 2Stl-28o2 

autopsies  to  determine ■....-.  — 244;i 

bureau  to  decide XT.-. 2318, 3757 

conflict  of  opinions  to  be  avoided 3761 

decisions  regarding .-.•. i-.-. ■.-.•. -.i-.v-  ••-  •   2S21-2837 

entries—  —  ■  •  ■  • ^ 

in  health  record .-.-.■.y  .:■...  .-.-.-.•.;..■.■.■.•.>■.-.•.•.-.-. -. -. 2254, 2256, 2824 

of  adverse  nature ..v^^.-.^..-.^ .-.-.. ■..-.-..... 2111-2817 

when  several  diseases  exist..... .,...^..,. >-...■.•.>-.. •....-.. 2259 

laws  relating  to i;.''.'?lU.[«i.i.V;iFWiiJ.aAA'. 2<<m-2803 

on  report  of  death — ..  — .....  — 2401* 

opinion  of  commanding  officer 2441' 

statement  of  opmionol —  .■..........-...•-. 242'i 

when  record  is  incomplete ....■..•.•.-..•.•.•.■...-.■.•.■.•.•.•.-. 2411,2441 

liquoi-s:  —  •■•••'' 

cresolLs  compound,  disinfection  by -. -.v.  .■.■..-.•.•.•.-. .-..■.•.•.■.•.-.'.' 2753 

custody  of ...•........•.-.•.•.•...•...■.•.•.. 801,827 

intoxicating,  forbidden  aboard  hospital  ship 1714 

kept  under  lock  and  key 146;* 

loss  of  pay  for  disability  due  to  use  of 804,832,924 

not  allowe<l  in  wards 1515 

list-s: 

binnacle .  s^t8, 4121 

clothing- 
disposal  of ;...-....-.;  :::-.  :.;-.-. -.-..  136.T 

veriUcation  of i .........  i  ...-.•.-.•.•.•..•.■. .  1502 

descriptive 2077, 2101-210.'> 

on  pension  certificate •. . .  3751 

headstones  for  unmarked  graves 4131 

lilwrty.    (See  Llljerty  list.)  ■■• 

light-duly -..;:•.•..:. 1467 

monthly  money,  preparation  of — .:. 1527 

patientH 1256 

special  diet :ftn3,396l 

slips,  shipping  articles,  and  enlistment  reoord-s  forwarded. . .  8985 

litters,  one  for  each  2  stretchermen 1S4<'. 

living  spaces,  inspection  of 855 

Lock,  drugs  kept  imder 1463 


INT>EX.  368 

Lockers:  •'        Paragraph. 

articles  to  be  kept  in -  - '--' -^.'fA  -  • 1511 

r      care  of -  - ■— - — ■"•■ ^^^^ 

dressing  stations  to  have - ^.-:d.vil  IiAi^i  i. 1«24 

Locomotor  ataxia,  method  of  entering ..Jiilia^^JiJi?. . .     225?t 

Log,  ship's:  

deaths  entered  in I.yAClu:-'. 3«2, 2434, 3432 

desertions  entered  in ■-!  .iaaUrnQqiiS  ,i<J.-i(??iiPM^.q..?J'i-. . . .      3432 

hospital  ship •'■'-  -  •   -    ^"^^^ 

Loitering  in  wards  not  allowed .....:... 151  < 

Longevity  pay,  nurses,  calculation  of. . . .  - —      722 

Loss  of  medical  stores ....■■863,2952,2962,3523 

Machines,  traumatism  by *  • '  »^'^-  -  -  • ^335 

Machinist,  physical  examination  lor .■.jlii  .-Lia-jiXlOJ: . .' : . ; 1932 

Mail,  laws  for  forwarding  pathological  specimens  by .-.xaYi.  S'.'A>^i-. 3229 

"Maine,"  pensions  from  destruction  of ■  •   ■^7*5 

Maintenance:  — -•- 

cost  of,  from  bill  book •   ■   ■• 1^84 

statement  of  cost  of 1421-1425,4131 

Malaria: 

precautions  against ■ -■■■  261.5, 261i> 

rejection  for - i  .:.■....-.... 2079 

Malarial  ports,  anchorage  in 26(J6 

Malingering: 

to  bo  reported - - ' ■- ^^^ 

use  of,  as  diagnosis - • -.-....•.•...•^-^^^.-.  .-.-j^.-- 2332 

Malt  Uquors,  custody  of Utjcvwf  *noma«.'o;ACi..- .      827 

Management,  economical,  of  liospirals.  re~ponsi'oility  for 12^1 

Manual  for  the  Medical  Department: 

authority  of  bureau  to  issue 1-^ 

regulations  included  in 1239,1282 

Marching,  defects  of  feet  interfering  with 2069 

Marine-s : 

barracks,  sanitary  condition  of ...■..'.: 2594 

Corps —  ■-•^ 

age  of  candidates  for nftsifHi-:. 1965 

charges  against  aijpropriation "^ 

deduction  from  pay  for  naval  hospital  fund 3602, 3ti06, 3621, 3651 

enlistment  in -  2005,2018 

Form  No.  330 •  ■   - -■  •  2095 

funeral  expenses •-■• ^'^'^ 

officers,  appointment  of -...-- .-.-^.- 1908 

paymasters'  clerks,  physical  examination  for :jij'.';ba'i'.'?0.' 1935 

promotion  in,  physical  examination  for i . . . .-; - 193- 

servicein,coiuitsasreenlistmpnt 2054 

transfer  to  hospital -  ■ -  •  -  -  -  -  -  •  -  •  - 2990 

transportation  of  dead -  - -  - ■^^'■^>  3^42 

visual  acuity  required. — -  -  -  - — - — •  -  — ^^^^ 

expeditionary  force —      • ..-.-■ 

baggage  allowance -- -.— -— — ......^-...-.•.•.vr; 1847 

service  with •-•-- — ..^..^.i.^-.  .^..- 184/ 

honorably  discharged,  preference  of .l^)i^P!\: 2150 

not  assigned  as  chief  pharmacist's  mates - —      4.53 

physical  examination  for  enlistment. 2018 

recruit  depots,  entry  on  Form  X ■  —  2053 

reenlistment  of,  with  physical  disability 2010 

Marks  entered  on  descriptive  list..- 2103,2104 

-au22t .' 


364  INDEX. 

Master  at  arms:  Pifa|ir4t)h. 

brigs  visited  by ...■.■^^^liJiV'A:: 13(>8 

hospital,  duties  of ....■...-..-...■ 1431-1435,1502 

propertj'  of  absentees  cared  for  by 1466 

Master  of  hospital  ship.    (Sfe  Hospital  ship.)  ^ 

Matches,  expenditures  for : •. 1402 

Material,  survey  on.    (See  Survey).  nJ  L<yi9)flo 

Mathematics,  professor  of,  appointment  of v . . .. . ri.t?7?t '. 1906 

Mattresses:  ..-■ 

care  of J:rr::'::.  '.....i. 2513 

.       disinfection  of .v ; 2767 

requisitions  for 3421 

Meals,  inspection  of 1305, 1362 

Measurements,  medical  officer  to  make : 2059 

Medical  aid  to  persons  not  in  Navy 899 

Medical  attendance: 

allowance  for .' 3341 ,  3351-335? 

expenses  for 3351 ,  33r)3-3357, 3362 

officers — 

entitled  to 1222, 3357, 3361 

families  of v 913,  si4 

traveling  under  orders ^.  ,,.^^., j.- .,.•..-.• 3343 

recruiting  duty 1;!  .V'.'::':'^7i.'. 3365 

ships  in  reserve • 906 

specialists 3355 

to  nurses , 711-715 

when  no  Government  hospital „, ., 3356 

Medical  certificate :  >        -<  =  i<  j^ 

civil  employees .'.;'.;'...; 2131 ,  2152 

court-martial  proceedings , 895 

St.  Elizabeth's  Hospital  for  Insane ......ji-. 4001 

member  of  general  court-martial •. . .  j C'.i.\'  yii'.'l ^7 

Medical  Corps: 

a;;c  of  candidate  for 19(i5 

appointment  in 111,116, 121-12»,iJ31-152 

candidate  to  have  physical  examination ; 1951 

correspondence  school  for uuncL 3230 

examination  for  admission  to i...';JeJi\4:0£tlC7WI.\<ii.Vi<:,vi>.:j.'l\i.V-.Jt':'i'..    3214 

merit  roll  of  candidates  for .■.'.";.''.V.^. . .    4131 

Naval  Militia ■  271-273 

number  of lOi 

organization  of 101-104 

physical  examination  of  candidates ■.ui-iL-.w 1951 

visual  acuity  for  admission ...■. 1963 

Medical  Department: 

appropriation 72, 3383, 3400, 3671 

bakery  used  by,  after  battle 1828 

dental  officer  assigned  to 1023, 1031 

duties  of 12 

entry  in  bill  book 1397 

field,  organization  of isi  i  isf.o 

galley  used  by,  after  battle ...jj.i ;•;■;!. 182S 

Hospital  Corps  attached  to 402 

inspect  ion  of _. . . .  w. . .....  i. .  j ....... .V. ..  Jj '  891 

by  fleet  surgeon ■. . . Ill's,  1132, 1162 

journal  of.    {Sre  Journal.) 

landing  force  organizat  ion 1S41 

Manual  for,  authority  of  bureau  to  issue 13 

organization  in  field 1861-1869 


INDEX. 


865 


_     ,.       J  Paragraph. 

Medical  Department  — Contmued.  1801-1832 

preparation  for  battle ^gQ^ 

provision  for  care  of  wounded •  -  ■  •  - 4101-4131 

reports  and  returns,  instructions  regarding ^^^ 

>  i'    sanitary  duties  of '" ^j^^ 

If''  ships,  report  of  inspection  of - ■- , ggg 

'       United  States  Navy  charges  against  appropriation.. .• 

Medical  examination  (See  Examination,  physical):  ^^^ 

board  of ^.  .  ,  §24 

Medical  history,  patient  in  civil  hospital - -- -■-----•-- ------ ^^^ 

Medical  inspectors,  professional  examination  for  promotion. .  ...•.-.-.•.■.-.•.•.■.•.-.•.•.•--.-.•-•. 

Medical  journal.    (See  Journal.) 

Medical  oflScer-s:  g2Q 

i'     absence  of,  next  in  command  succeeds .■.".".'"'.".'.".'' 2209  3756 

l'<-   accidents  in  absence  of • " '  "]^'". '  2931 

i^' '    accompanies  patients  to  hospital -  -  ...-.--•-■---  ------ ^^^ 

I''     aid  to  persons  not  m  Navy - ....•...-.  .-■.--  -  -  -  - ^^^ 

i      annual  physical  examinations -  -  -  -  • -        '  ^.^^ 

w     applicants  for  pension  exammed  by. ","  ■:,:■": 2249 

'-approves  entries  m  health  records ..-.-.-..... ---•- ;■••;•  2591:2597, 2031 

?      at  stations,  duties  of 

if     attendance—  ^  ...913  914 

■  onfamilies ''"''"[][''''''  __■  -■•  'gll 

'■"'■■  authority  of ■--■ "  \' VV' '  \\\\\.' .'.'.' 'lei  c  &j^]. v..  :*6, 3780, 2721 

billsofhealth "  "    .  848 

binnacle  list g53 

bumboat  inspections 

care  of —  903 

inflammable  stores ^222 

poisons ■ gjg 

y  -  wounded ■ 

'       certificate —  ...821 

of  ill  health ' 2989 

•  to  accompany  accounts ',:"' 8022.=^!  254-? 

■■'      commanding  officer  to  consult  regarding  health  of  crew - 802, 2o31, 254o 

consultation —  g4g  §33 

regarding  treatment ■""■ '^^^^ 

i/  with  fleet  surgeon " ' ' ' " ',' " ! !  ^"  812  828 

"     contagious  diseases,  report  of .."^.. '......:"/...    '829 

.    court-martial  records ■.....•--- " '  "^_"^' '^ " " "  " " '_][;_ _;^  _  _      §27 

custody  of  liquors V"'l-"' 1025.1834 

dental  officer  to  inform  of  condition  of  patiems .-.•..y-.^^ .  ^^^ 

detached,  inspects  department  with  relief ----- -  --  ■-  '  ' ^^ 

disabUity  of,  next  in  command  succeeds -  --  --  ---^^^^Q  \  ...'../^..    2215 

disability  report  in  absence  of - """"""""^r^"^.^^^— -v. 812,828 

diseases,  contagious,  report  of •  • '  'y"' '^"^""7.  :r.r.  801-1012,3511-3525 

dutiesof 869 

as  division  officer [['^''^.H^ls^tLlLzliii^^. 2581-2584 

at  hospitals '       "  [f^.  ^^.,,^, ^..^ 938 

at  Naval  Academy ......^v.---.»-^»->-»     ,....t 931-938 

at  navy  yards - ^ "m^Ui'^)../..... .......-.- 937 

atprisons - ,   .,'"     6U,»12, 3591-2597, 2631 

at  shore  stations * .\...._.j^jwi)i'.'V--.....  981-987 

during  drills • " ; "■'^■^-.^i.C^^.:,. &41 

going  into  commission "'"'i':'W;lil^'Ju."."...! 864 

going  out  of  commission - '  ' Mgu/j^... 868,869 

in  battle '"...' 2581-2586,2632 

on  hospital  ships 


366  INDiiX. 

Medical  oWlcer-s— Continued. 

<lutie.sof—  Paragraph. 

on  ships -.•.-.-,-.-.-  -.•.•.-.-.-.-.•.-.•.•.•.•.■.•  :■■■ ••-••••  :^l-'2678, 2601-2618 

with  labor  board ^p^t^ivn-tnff.  i  lyi-ai  -.tf  »Hf  v>  •  f 2141-2154 

with  landing  part  y ....,......_.............._._.,....._........ .......  ..->,,.  ♦„ 2621 

■     employees,  compensation ....._..._.._....  .^..i^ . ,,  jj.,,-^^;,  ^, 921, 931 

epidemic  diseiises,  report  of .......,sr.:u^,■rt«^{e'^«>'M■'^»•?>•'•^♦•■'*-••'•'*i<•.r 812,828 

examination —  i  ;    ■  ulfioizvifr 

injured  employees ...............l... 2172,2175 

men  before  transfer ^...j..^^...^.. 828 

pensioners .....„^^,j<sw,j-itSiifti->t.rr;*v r---      973 

recruits 94 1-952 

fire  and  rescue  party  accompanied  by 984 

flrst-aid  instruction ^i,^^j.ji,^  hatsmtaov  i-i^)^  849, 909, 1001-1012 

fitting  out  sl'ip ...........................),,  ,j.,_t/^j5.,.^g,,,....      841 

fleet  surgeon,  duties  of .h.>j^»-^  ,>>  ni^jj^ftfj-iiSM^fK..-  1101-1173 

food ,  preparation  of —  ............._.•,,„/-'-  tiJ-v»pr-s...-»*«^n»*  J.  ;  851 

health  officer  received  by •.•.•.-.•.-.--tasti-iT,-^! -(f!it/'»4«'ni!*.''1"'''"««'»2722 

health  record-s -..•-- ....v4;^,iifL.v..- ..»,....;.,.      857 

in  absence  of ^.^.j,,,,,, 2215,2266 

kept  by 2222 

opened  by 2243 

Hospital  Corps  to  summon — .... ............ . ................ ..^ ,. . .     845 

hospital,  duties  of .........................._....._..„ 2581-2584 

hospital  ship,  duties  of — -.-•.•  .-.-.-..^-.•.•.-.- .-.......-,-.........{, ,  25|8il-2586, 2632 

in  charge  of  wards .■.•.•.•.•.•.•.-.•-•.■.-.■.•.•.-.-• 1228 

in  command  of  hospital —  .   .^uoi  SOO'. 

duties  of 1281-1295 

as  recruiting  officer --.-.-.-....  ..-.-...-..,...«t>».'V>ft.i-ieiK<t*» 127.s 

informs  next  of  kin i295 

responsibihty  of —  .■••.-•.-  • 1223 

returns  approved  by 1314 

to  order  summary  court-miirtial  and  deck  court. ..................,.....................................,{«.j,^.,,. 1277 

in  command  of  hospital  ship,  reports  from e*{Hie99ii-y.uu<f(.ws* 1741 

injury  occuiTing  in  absence  of .'.i,.;i.^.' .>,-•■.,  f^-'.-.fTix»  03- i-^Sfft*-;. 2209 

infectious  diseases,  report  of 812, 828 

inspectionof —  injn  ■■ 

bumboats ..j...,. .......  ,^......_. ....... ........ ............. ...«, 853 

cells .................................................!.>ji5,^,i:i 854 

food ••••.•.•.•...•.-.■...•.•.-.•.-.-.-.-.-.-........,.&'.»., 820 

holds — .......................  -•-.-.-.-.-  -.-.....  ...vv- 855 

Uving  spaces .^^kk^it*-!.. 855 

medical  department \.if,4^u 891 

prisoners ..„ 854 

provisions  for  crew .....t — 850,853 

storerooms , S55 

.• .  ir  I     transport  for  sick «««*„-,,„„, 3007 

:  <•■'  instruction —  

divLsion  oflicers,  in  first  aid .,.,,.,,,,,,/,....... 1821 

first  aid „.,,,,.  „.ra^JwtH8,  (449, 909^1001- 1012 

Hospital  Corps , , . . , , , ,,,,.,,,.,.,,,..., 910 

7u   journal  of  Medical  Department.    (See  Journal)., ...,,.,,...,...., 8tt4, 961, 2318 

V     Jtinior.    (.See  Junior  medical  officer.)  

:.     letter  lor  guidance  of ,,,,,,,,,,  2170 

inakesinquiry  concerning  recruit , .,....,.^,,. 2025 

maUngering  to  bo  reported  by , , , . . . , —jv^PtjoK. *«,■. »-«fc. 816 

navy  yards,  reports  by ,,.,,,,,,,»Ui»M 2175 

■idKlaiiqiutl  f. . 


INDEX.  367 

Medical  officer-s— Continued 

notified  of-  Paragrapli. 

contagious  disease  at  stations ., iV>-i':;'»i^i.~/:v=;^u^.V;i^:..    2598 

detachment,  promotion,  etc ..i,i.-,...i^^........,.';Vi71..    2302 

transfer  of  officers 2212 

officers  entitled  to  services  of 3361 

of  tlie  day,  duties  of ; vi  u  i . . .-; 1227 

on  boards  of  inquest 2420 

opinion  as  to  cause  of  death  required . crpisafiVr.'. .  .........    2422 

patients—  ?qiii.i 

in  civil  hospital „„. ,, - .  ^,v ,.....,.  ^ .. .  ACITi'l"  v.-. .      824 

received  for  passage .,,.^^,Ai'Ji<'Ai.F: sse 

pension  certificates  given  by. .'iVWaUJsJi^J.Uyf/l 375S 

precautions  against  disease g^s 

qualifications  for  services  determined  by , .\ . ..; 4347 

quarantinable  diseases  reported  by .,..,,...,,,.-.-.•.-,.,.-.- 2733 

rank  and  title  of ..-.-,.- .-.w.-.-.-.-.-.-.-.-^. 102 

rank  when  retired J.QOfIp.8  Jeoi^eMj 103  104 

recruiting  duty ...-  =  =  ..'  =  ..-  =  :;:;... 941-952 

discretion  allowed , ^ .  ^  .-.■.■.-fMWj'J-Sri^'i'.  1 2061 

recruiting  stations J.W??8Jk'i'. 922 

recruits  inspected  by. ..„ ". ...ijiis.-.-iis;; 2025 

report-s— ^ XtiV 

diseases  concealed ..,.-.-i4.-..ii.-ijj.-ii.-.-; 817 

diseases,  contagious ^ ..... ^ . : VL'Jl^. '.: : 812  828 

from  prisons 2597 

from  ships,  list  of .' 4121 

killed  and  wounded ,  .,.„.•.■.„<.-.-.. 819 

prisoners  and  brigs '29.7*l'.o.Tttii 898 

sick,  daily ii5^!l'il':;.  ti-.IV'l'; 847 

use  of  harbor  water ..•.-.•.■.-.-.-.-.-.•.--.-.•.•.•. 902 

use  of  intoxicants  or  drugs , • ... .-.  ..•.■.■.-.-.•.-.-.•.■.-.-.-.-.-.-.-. . . . ; 901 

requisitions  for  supplies .......... ..... .  ......•.•....•.•.-.-.-.•.-.-.- .-.•..^.- S59 

rescue  breathing  apparatus v.......  ..........•......-.-.-.-.-.-.-.•.■-.-:■..  • 1821 

responsibility  for—  .      C" 

correctness  of  certificate .-. . . .-. . . . .  .    3386 

health  records 2248 

recruits  surveyed 2024 

sanitary  data,  foreign  ports S28 

sanitary  reports.    (See  Reports,  sanitary.)      ... 

ship—  - 

care  of  wounded .V.'.  ";'•;!:.. .  1803  1804 

duties  of 256l'-25'78, 2601-2618 

duty  to  woimded  in  battle .' ......    1811 

instructs  ambulance  party  in  first  aid .-. 1804 

sick  bay  in  charge  of !-i 844 

sick,  daily  report  of ".■... 847 

spirits,  custody  of .v.-.'^V  .4V' soi  827 

station—  of 

at  quarters 'jgg- 

during  battle .......■.-.......•..-.■.•.■.....•.....■ 1824 

storeroom,  care  of .-.-.•.-.-....• S25 

to  accompany  serious  cases - •.-.■.-..•.. •..-.•.•...■.';  .'i^'.' ,. S23 

to  keep  bill  book •..•.-...-...•.•..•.-.■.: :'..'. ......  936  1381 

to  conduct  physical  examination  of  recruits . . . .  .-.v.-.v.-.-.-. 2022  2050 

transfer  of—  

insane 3134  3135 

stores ...-. . .-. .■.•.-.-.•.xi^?2??VP.". ....'..'...'..  865^ 3520 

vaccination,  duties  in  connection  with. . . . . .  .-...•..■...•.....-..-.- .il. S43 


368  iis^DEx. 

Medical  officer-s— Continuecl. 

^"<1-                                                                                                                               Paragraph, 
order  book  signed  by X467 


routine. 


1470 


i'  water,  analysis 852 

I  approved  by .j..ijii>.>.i 2.'>44 

-     with  landing  party,  duties  of ..,^.jii'.-.5l. 2621 

Medical  outfit:  h 

going  out  of  eommission _^ .; beahii\sxitJi\!d!  )i 864 

=^'"PS 3322, 3512, 3551 

in  reserve Ll.j,;Qc;;:/J.....      864 

Medical  personnel,  transportation  of isjo 

Medical  report,  to  Office  of  Naval  Intelligence _.v.i 2568, 2655, 2o61 

Medical  Reserve  Corps: 

.,,  active  duty  in  emergency -.t<.'.:.iiu- 231 

f,     age  of  candidate  for _.../. 19g5 

'.     appointments 116,132-146 

f,     attendance  at  Naval  Medical  School ....j;'. 259 

■^^^   ejcamination  for •.-  B«; 248, 254, 255 

J     governed  by  Na\'y  Regulations , ;...jn.'i 244 

^     instruction  at  Nava  1  Medical  School , _ 3215 

f    legLslation  relating  to '. 231 

pension  for  physical  disability 3725 

physical  examination  for 1922  igeo 

qualifications  for  appointment  in , , 241  •2.')l-255 

uniforms  required , 245,'  260, 261 

Medical  school.    (S«(?  School.)      

Medical  service,  neutrality  of 4203,4217,4240,4278,4310 

Medical  staff  of  captured  vessel,  neutrality  of 4217  4218 

Medical  store-s.    (See  Stores,  Supplies:) 

,,    allowance  of ., 79Jio..L.ja..ulio..j..      860 

,     distilled  spirits  in ..j  jj^.i;.' .,..'..  ^i. 13^....       801 

expenditure  of ..,  .;j gjg  935 

inflammable,  care  of t.,. g(^ 

invoices  of gjtj 

'OSS  of ■ 863 

purchase  of ggg 

receipts  for g^g 

requisitions  for j, ^      359 

room,  precautioiLs  regarding j  .ivt ) . . j>j.-hu}91  .-5 828 

Medical  supplies.    (See  Supplies.) 

Medical  supply  depots: 

construction  of ...........,„„, 7 1 

recjuisitions  on 3395 

surveys  at .....i..... 2855,2969,2974 

Medical  survey.    (See  Survey.) 

Medical  transport: 

Ued  Cross  organization  on 4;^! 

transfer  of  wounded  to j>y2 

Medlclne-s: 
.    administration  of ^343  1453 

j. ,    allowance  of  expenses  for ■ 3jj4j  3368-8365 

,,    inspection  of,  entered  in  journal ^ 2313 

1^  ls;>ue<l  lo  persons  not  in  Navy 1255 

kept  under  lock  and  key ^ , 14fl3 

refusal  to  take __    1453 

Member  of: 

C'o^^res;^,  physical  examination  requested  by .....,,»*jl..    1984 

gflneral  court-martial,  certificate  on ..-„,»  f Krfj.)e«»n««.a«  ..4 ii/i.Mw uaiwv .897 


INDEX.  369 

Paragraph. 

Uembranes,  tympanic,  condition  determined -- 2076 

Memorandum: 

billoflading 3998 

personal,  for  Suigeon  General 4121, 4131 

Men,  enlisted.    (See  Enlisted  men.) 

Meningitis,  cerebrospinal,  quarantine  f o r 2733 

Mental: 

defects,  detection  of -  -    2026 

infirmity — 

certified  free  from 2085 

rejection  for 2079 

stability  to  be  determined 2063 

Merchant  crew,  hospital  ship  manned  by 1705 

Merchant  Marine  Service: 

liable  to  draft 3737 

pensions  for 3737 

Mercury: 

bichlorid,  disinfection  by 2753,2761,2762,2765 

biniodid,  disinfection  by 2753 

Merit  roll  of  candidates  sent  to  bureau 19Wj  4131 

Mess-es : 

attendants,  intestinal  parasites  in 2117 

gear- 
appropriation  for 1397 

sterilization  of 2615 

hospital  ship,  arrangement  of 1721 

rooms,  inspection  of 1362 

special  to  tubercular  patients 2615 

utensUs,  cleanliness  of 2544 

wardroom,  special  diet  from 3422 

Mexican  War  veterans,  pensions  of 3715 

Microscopical  outfit: 

appropriation  for 1393 

going  out  of  commission ^4, 3204 

obtained  from  Naval  Medical  School 3204, 3.555 

requisition  for 3555 

Microscopical  study,  preparation  of  tissues  for 3225 

Midshipmen: 

age  of  candidates  for 1965 

chest  expansion  of 2084 

health  records  of 2306 

height  of 20S4 

injuries  in  line  of  duty 2835 

pensions  for 2S36 

physical  examination  of  candidates  for 1971-1997 

weight  of 2084 

MlUtary: 

duties  of  Hospital  Ck)rps 422 

laws.  Red  Cross,  subject  to ~  " 4343 

service,  statement  vmder  oath  concerning : -.'..^j..; ^^'"9085 

MlUtia,  Naval: 

appointment  in  Medical  Corps  of 271-273 

checkage  for  hospital  fund 1208 

officers  and  men  in  hospital 12C8 

pensions  for 3726 

physical  examination  of - 1913, 1966, 2006, 2088 

98601°— 17 24 


370  i^^i>EX. 

Minister:  Paragraph. 

piiy  for  services  of """^ 

services  of  at  hospitals '•'^ 

Minors: 

enlistment  of— 

consent  required 2004, 2056 

fraudulent ■■    ^** 

prohibited 2001,2014 

table  of  chest  measurements  lor 2084 


table  of  heights  for. 


2084 

table  of  weights  for 2084 

term  of 2003,2055 

not  recommended  for  flreman 2005 

when  entitled  to  pensions ^^^^ 

Miscellaneous  column  in  bill  book l'**J2 

Misconduct:  „„,„  „^^ 

admissions -2818,2^20 

death  due  to ..242-5,2801,2834 

disability  due  to ...:.:.;  8W,  832, 924, 2251 

discharge  of  nurse  for --■■ ^^''^^'l^ 

officers  not  retired  for - •  -  —  - 2802 

j.^pQ^ 1242.  ISfio,  2818, 2820, 3915, 3922, 3972, 4121 

Money: 

deposit  of  in  safe J^  _ 

lists,  monthly,  preparation  of ^•'2' 

patients',  to  be  safeguarded 1330,1404 

Moral  inflrmlty,  rejection  for. 20*9 

Moreue,  master  at  arms  to  supervise 

Morning  report  of  patients •-'•''-'•■''f'^ 3967,4121,4131 

of  sick  on  ships *'~ 

Morphln  habit,  evidences  of 2063 

^  2440 


Mortuary  reports,  preparation  of 

Mosquitoes:  „,,.,  „  , 

desiruCionof 27o3,2.b 

protection  from 2^.13,2615,262 

Mounted  officers,  hoise  equipment  for • ^°^' 

Movements  of  Hospital  Corps,  report  of •--- ^^^J 

Mud,  remov<>d  from  anchor  and  chains -'--'t-L ..j.iytu=.-jia33c. . . l...i.:j.-^ 2611 

Musician.    (Ste  Apprentice  musician.) 

Musters  not  to  be  hold  on  Sunday '■^^ 

Nails,  Ingrowing: 

entered  on  report  of  rejection 

rejection  for 

Name-s: 

entered  in  liealth  record ''' 

recorded  in  journal 

Narcotics: 

intemiKjrance  in  use  of,  rejection  for ^' 

kept  under  lock  and  key 

Nasal  septum,  deviation  of 

Natives  of  Insular  possessions  are  supernumeraries 

Naval: 

Academy—  ^ 

ago  of  candidate  for '"'^''  '^';^ 

dental  surgeon  at ^ 

duties  of  medical  ollicer  at • 

physical  examination  for  adinission 1971-1997 

I)relimijuiry  physical  examination  for - ^  1 1' • 


10- 20S1 

1981,2079 


1981,2079 
...     2247 


1984-1980 


INDEX.  371 

Naval— Continued,  Paragraph. 

Auxiliary  Service „ 131, 251 

dental  services  to 1032 

health  records  for 2245 

personnel  in  hospitals. 3011 

medical  officer  to  e.xamine 2089 

constructors,  appointment  of 1907 

home.    (See  Home,  naval.) 
hospital.    (See  Hospital.) 

fund.    (See  Fund,  naval  haspital.) 

hygiene,  department  of y38 

Militia,  Hospital  Corps 5.31 

transfer  to 261 

stations,  duties  of  medical  officer  at 911, 912, 931-9.38 

Reserve  Force — 

dental  surgeons 301,347-304 

Hospital  Corpsmen I02 

how  to  enter  names  on  forms 3936 

medical  officer  in 231 

age 137 

allowances 131, 258 

application  for  entrance • 252-253 

certificates  required , ..;.  ^^v.  .,1 253 

confirmation  in  grade .:»: .: .-.rji^ 131, 262-2tJ4 

examination  of ^  Li.. ; 254 

final ;.:.,;. it.^. 142-146 

professional j 140 

physical 139 

where  held 133 

length  of  service 131 

number  of.  limited 265 

oath  of  allegiance 131 

pay ^i-^l&j.sii. 131 

retainer  pay ^.s^.ccIj. 131 

transfer  to  Volunteer  Reserve 261 

uniform _. -. 266 

at  Naval  Medical  School 267 

nurse 414, 560-565, 790-796 

oflicers  and  men 393tj 

typhoid  prophylaxis 2087 

vaccination 2086 

volunteer 251 

women 2043 

Navy: 

pension  fund.    (See  Fund.) 

Red  Cross  cooperation  with -.'eJiti^j^i.  aj.:\ 4331, 4341-4360 

relative  rank  in  the 3731 

revenue  cutters  cooperate  with 3723 

service  in — 

counts  as  reenlistment 2054 

statement  under  oath  concerning 2081 

vessels  of,  are  subject  to  quarantine  inspection 2732 

yard-s — 

duties  of  medical  officers  at 911,912,931-938 

employee's  compensation 9^:1,931,2161-2175 

forms  used , 2175 

employees  injured  at 917 

hospitals  at 7,5 

medical  officer  examines  for  pensions 3758 

medical  supplies  at 918 


372  INDEX. 

Havy— Continued.  Paragraph. 

yard-s— 

reports  and  returns  from 4131 

requisitions — 

for  supplies 3531,3541 

from  ships  at 3324, 3327 

service,  physical  examination  for 2121-2176 

Nets,  mosquito: 

landing  parties  to  have 2621 

use  of,  in  Tropics 2613 

Neurotic  state,  rejection  for 2079 

Neutral  IndiTidoals: 

continuance  of  pay  after  capture 4212 

to  wear  brassard 4208 

Neutrality : 

cessation  of 4202 

of— 

ambulances 4202 

boats  carrying  wounded 4216 

chaplains 4203, 4240 

evacuations 4207 

hospital  ships ..' 4272-4276, 4301-4304 

hospital  staff  of  captiued  vessel 4217, 4278 

bouse  containing  wounded 4206 

inhabitants  aiding  wounded 4206 

medical  staff  of  captured  vessels 4217, 4278 

merchants  ships  carrying  wounded 4220,4277,4309 

military  hospitals 4202 

personnel  of  aid  societies 4241 

persons  employed  in  hospital 4203-4205, 4240 

religious  stall  of  captured  vessel 4217, 4278 

suspended  because  of  abuses 4224 

Neutralization  of  hospital  ship 1708 

Nevi,  extensive,  rejection  for 2079 

Next  of  kin: 

address  of,  on  admission  report 1467 

deaths  reported  to 1295, 2413 

entered  on  health  record 2241 

wishes  of 3455  (6) 

Night: 

apprentice,  duty  of 1 481 

duty,  nurses  detailed  for 1443, 1454, 1455 

reports,  hospital .- 1364 

soil,  precautions  where  used 2604 

"No  disease,"  use  of,  as  diagnosis 2332 

Nomenclature,  Bellevue  Hospital 2323 

Nomenclature,  Navy: 

arrangement  of 2323 

classification  of— 

causes 2335 

diseases 2358 


uijuncs. 


2360 


jwisons 2361 

key  letters 2325-2328,2335-2337 

object  of 2322 

to  be  used 2257,2321 

Notation  on  forma 3936 


INDEX.  373 

Notes:  Paragraph. 

bedside,  nurse  to  make 1 461 

clinical — 

form  for 3969 

nurse  to  make 1 467 

Notice: 

of  waiver  of  physical  disability 2064 

ration — 

admission,  Form  S -  1276, 3013, 3922, 3948, 4131 

discharge,  Form  T 1276, 3013, 3922, 3948, 4131 

Not  inline  of  duty  (See  Line  of  duty): 
entries — 

on  health  record 2207,2254,2259 

procedure 2355,2811-2817 

survey  for  disease 2906 

Number-s : 

class,  of  diseases 2358 

international,  of  diseases 2358 

loss  of,  when  failing  professionally 166 

Nurse-s: 

authority  of 1441 

breakage  reported 1465 

chief.    {See  Chief  nurse. ) 

communication  with  commanding  officer 1451 

conference  of 1443 

deduction  from  pay  for  naval  hospital  fund 3624 

diet  kitchen,  duties  of 1450 

duty-ies— 

assigned  by  chief  nurse 1443 

continuous,  length  of 1453 

entered  in  day  book 1445 

in  hospitals 1441-1470 

in  venereal  wards 1453 

health  record  for 1445, 2244 

hours  of  duty 1452 

knowledge  required  of 1442 

linen  room,  duties  of 1450, 1455 

Naval  Reserve,  in 790-796 

night- 
duty  of 1454,1455 

information  to  officer  of  day 1468 

orders  given  to 1468 

report  by 1468 

not  to  be  called  from  station 1458 

officer  to  be  accompanied  by 1459 

operating  room,  duties  of 1450, 1 J55 

physical  examination  for 1934 

quarters.  Government  property  in 1445 

registers  of,  kept  by  chief  nurse 1445 

reports  submitted  by 1444 

requests,  official,  submitted  by 1444 

sickness  of 1446 

sick  records  of 1445 

supervised  by  chief  nurse 1449 

term  not  applied  to  Hospital  Corps 492 

ward- 
absentees  reported  by 1460 

administration  of  medicines 1463 

bedside  notes 1461, 1467 


S74  INDEX. 

Korse-s— Couiinucd.  Paragraph, 

ward— 

bookskcplby 14C7 

breakage  reportwl  by ...-.;......  i :. :';'. 1400 

daily  routine - 1470 

discipline  during  absence 1462 

duties  of • 1450,14-)ft-1470 

forms  kept  by 1467 

Hospital  Corps  men  detailed  by 1465 

hospital  property,  care  of ;...■..... 1460 

keys  kept  by ::.■...:. 1462 

liquors,  care  of 1403 

money  of  patients  safeguarded ; 1464 

narcotics,  care  of - . . ; ; 1463 

patient  confined  in  brig ; ; ; 1400 

patient  restricted  to  ward 1466 

poisons,  care  of ;.;::.: 1463 

responsibility  for  condition  of  bed  patients .V.' .' .;...:.. 1461 

valuables  of  patients  safeguarded 1464 

Nurse  Corps: 

administration  of 611 

allowances  of - 616,619,624,721-732,751-753,761,762 

appointment  in - 611, 614, 641-647 

revocation  of :.:.y.:'.'f: 728 

Army,  service  in - 722 

assigiunent  of '..".■.'.". :':'.'. .''.  1 .-. .'i.V...: 671-677 

authority  of : .'..'.'.■...;.'.. 617 

badge 771 

change  of  station : • 676 

changes  in— 

entered  in  journal 2317 

to  be  reported 702, 707 

chcckage  for  hospital  fund ...:..:..::::. 730 

chief  nurse.    (Se«  Chief  nurse.) 

communication  by  official  channels 708 

commutation  of— 

quarters ; ,.....:..::......  618 

rations ::::::.;:;::::::..  741,742 

composition  of 613 

detail  of : : 615 

discharges  of ;.....;..;.....;..........:.;; 691-099, 710 

duties  of  superintendent ;;...;;;:;.;...;..;...;..;:;;... 015 

offieiency  rcr)0rts ;..:.:.;: ::.;:.....:...:...  072r. 70-1, 4131 

eligible  list ;  -  - ..:.:.  647 

citablishmcnt  of 601 

examination,  supplementary 6726 

executive  surgeon  to  supervise 1305 

fuel  iillowunce 619 

health  record,  custody  of 717 

illness  of 711,717 

illniss  of  confidential  nature :....... ....... ■..':..-• —  706 

information  slip ...■.•.•.•:..•.•...■.•.•.■...•.•..  4131 

instruction  of ......•.•...•..• .■:..■.■.■. ■:...:.'.\-.-:..  611 

laws  relating  to ...........■...■...•.•..•.•..•....  (V)l,002 

leave  of  absence ;.;... •.•.•.::?'; OSl  689,702 

final »^'» 

longevity  pay,  calculation  of 722 

medical  atli-ndiinco  to .•...•...•..•.. .  .'ll-7ir. 

nionthlv  return  of .-.. 4131 


INDEX.  *  375 

Nurse  Corps-Continued.  Paragraph. 

orders  home ...,.izi.\:. 697 

pay  of 602,616,721-732 

places  when  eligible  for  duty - 620 

probation 672 

quarters  for 751-753 

commutation  of 618, 753 

rations,  commutation  of 741, 742 

registration  required 643 

removal  of *  wts-Mi  -iur-- 611 

reports  concerning •-•- 701-708 

requirements  for  appointment 614 

Resei-vc,  Naval  Force •. 790-796 

reserve  nurses 621, 781-784 

returns  of -  -  - 701-703 

revocation  of  appointment « 672 

sale  of  stores  to • 732 

services  to  families - -  •  •  •  • -  • ■ 671 

special  nurses,  employment  of ,  i.>:>,-.  *, . . . ,      623 

subsistence  of -...-.- «»;-,. vf  721, 741-742 

superintendent — 

allowances  of 7.30, 751 

appointment  of 631 

duties  of 615, 631-633, 2244 

pay  of ^2 

surplus  to  be  reported 674 

tour  of  duty , 673 

transfer  of ,,^...5^,,>,>,,, ,.,...,,^..,,673-677,728 

transportation  and  travel,  expenses 761-762 

treatment  by  specialist —  - .  ■.-.-.-,-,-.-.-.-.-..■.-.-.-.--.•.•.-.-.-.-.- .•.-?i,H*j-i-k;i-; "^^ 

uniform ,,......,.,,..,,,.....,,,,..,.,.., 771-774 

Kursiug,  instruction  in ..,,,,,......,,,,,-,...... 1375 

Oath:  

candidate's  statement  under -.1^5.  .,inli0s»i,^"-  ■'■ •-■--■ 1958 

of  allej^iance,  recruits  to  take '- '--,- 2081 

of  office  and  acceptance .-.--.-.- >  •,tb«»-.-k'i''-- ■  ■  ^ •  • ^^" 

recruit  makes  statements  under .,,.,,...,......,...... .,-.-,;v-r, 2081 

to  contract  required ----- -  -  - 3309 

Obedience  to 

authority  required 1729 

orders  required 1281 

Obesity,  rejection  for • ■ 2061, 2079 

Occupation  of  recruit,  entered  in  health  record ....-,,.,,...-,-,-.. 2241 

OSenses,  punishment  for,  in  hospital ...,,.,,........ 1285 

Office  of  Naval  Intelligence,  report  to ......-.-.,, 2o60, 2655, 2661 

Oflacer-s: 

always  on  duty  in  port l''^-* 

appointed  by  President  with  advice  of  Seiiate 1902 

appointment  of 1901-1997 

assigned  to  laboratory  work 131" 

baggage  allowance,  expeditionary  force r 184" 

Coast  Guard,  pensions  to - -  - 3724 

day  off  duty •.--.-.-.-.- .-x**-  iv''--" -  • 1^'^ 

death,  report  of ----■  —  :-•!:•-:-->'.>!-- 2433 

deck.    (See  Deck  officer.) 

deductions  from  pay  for  naval  hospital  fund 3002, 3G0ti,3Q21, 3625, 3651 

dental,  forms  part  of  surgeon's  division ,,.,..,,., 331 

hospital  apprentice  to  assist ,.........,..-:.,- , 474 

detached,  entered  in  journal - 1  - 1^62 


376  '  INDEX. 

Offlcer-s— Continued.  • '"  '  Paragraph. 

detailed  for  special  duties -  -■-  -  .-.•-•.•.•• .  -•-  -■'-•-■-  -  - 1352 

disabled— 

wititled  to  medical  attendance 1222 

may  go  to  Naval  Home 1221 

pensions  for 3711 

pensions  for  widows  of 3712 

discharge  from  hospital,  report  of 1221 

division,  first-aid  instruction  of 1813, 1821 

entitled  to  remain  in  hospital 1221, 1222 

examination  for — 

appointment,  health  record  of '. 2303 

promotion,  health  record  of *. .^.'  -  —'1 . ; ■: : : : .  .■ 2303 

retirement,  health  record  of 2303, 2304 

field,  baggage  allowance  for 1847 

first.    {See  Firtt  officer.) 

first-aid,  instruction  to 909 

funeral  expenses  of 2402,2405,3441,3454,3456-3460 

health  record—  '''  '■ 

accompanies ■-■•-"- -•  - -• 2301 

custody  of 2211 

opened  on  appointment  or  promotion 2232 

in  charge  of  stores,  death  of 2953 

medical.    (See  Medical  olBcer)— 

attendance  to  families 913, 914 

history  sheets  of  health  record  of 2305 

officer  notifies  of  transfer « 2212 

survey  on 2903 

militia— 

checkage  for  hospital  fund 1268 

in  naval  hospitals -' 1268 

physical  e.xamination  of 1913, 1966, 2006, 2088 

mounted,  horse  equipment  for 1847 

notify  medical  officer  of  detachment,  promotion,  etc 2302 

of  the  day- 
ambulance  book,  entries  in 1363 

brigs  visited  by 1368 

detail  of 1333,1334,1353 

duties  of 1227, 1361-1369 

fire  drill 1369 

Form  F  (rough),  entries  in 1363 

health  records  supervised  by i... ;..... 1363 

inspection  of  hospital jll.'.'Vl..-.  if;'.::'.'. 1361 

journal  kept  by 1362 

journal  supervised  by 1363 

keeps  journal 2314 

liberty  list ...i^i:i:..j 1366 

master  at  arnw  accompanies :..:.'...'...;....'..';...' 1368 

meaLs  insp«cte<l  by ; 1362 

night  nurse  informs,  of  emergencie? 1468 

night  reports 1364 

office  always  to  be  open 1361 

patients  received  by 1501 

pharmacist  as 1294, 1333 

physical  examination  of  all  patients 1367 

quarters  occupied  by •  •    1361 

register  of  patients,  entries  In 1363 

reliofof 1362 

reports  condition  of  hospital 1304 


INDEX.  377 

Officer-s— Continued.                                                                                                                    Paragraph. 
of  the  day- 
sick  call,  evening 1368 

to  inspect  meals - 1325 

of  vessels  to  be  citizens 1901 

on  detached  duty,  health  record  of 2302 

on  waiting  orders,  health  record  of 2302 

ordered  before  board,  notifies  medical  officer 2302, 2303 

physical  examination  of 908 

for  appointment  as 1951 

physical  exercise 908 

posts  of,  in  parades,  drills,  etc 1854 

proceeding  under  orders,  medical  attendance  for 3343 

promotion,  physical  disability 1909-1912 

report-s— 

from,  after  battle 1815 

of  admission  to  hospital 4131 

of  discharge  from  hospital 4131 

of  fitness , 3981,4131 

of  sickness  or  injury 3352, 3363 

reporting,  entered  in  journal 1362 

required  to  submit  reports 4107 

retired — 

death  report  of 2437 

health  records  of 2246 

when  not  promoted 1909, 1941 

reviewing,  post  in  parade,  drills,  etc 1854 

(See  Medical  officer,  Junior  medical  officer.  Executive  surgeon,  etc.) 
sick- 
entitled  to  medical  attendance i ..... .,^.  f. 1222, 3357, 3361 

expenses  for  medical  attendance .,....,.. 3362 

hospital  routine  for i 1491 

surveyed  in  hospital 2913 

termination  of  appointment,  health  record  of , 2304 

transferred  to— 

hospital,  report  of 122i 

Naval  Home,  report  of 1221 

typhoid  prophylactic  administered  to ^ 2086 

use  of  drugs  or  intoxicants 2812 

vaccination  required •. 2086 

woimded,  entitled  to  medical  attendance 1222 

Omissions  from  health  records 2307 

Open-purchase  requisitions.    {See  Requisitions.) 

Operating  room:  >,;ii.h,' 

hook ,  1 ,...,.,.,. , 1350 

care  of 1315,  i350, 1450 

furniture,  requisitions  for 3421 

technique,  iastruction  in 1375 

use  of,  after  battle 1829 

Operation-s: 

defects  remediable  by 1985, 208162 

report  of,  Form  P , 3922, 3946, 4121, 4131 

surgical,  necessity  for -.-Js.w>j«»f  -  - 1287 

Orders:  

book  kept  by — 

nurse 1467 

ward  oflBcer 1342 


378  INDEX. 

Order-s— Continued.  Paragraph, 

for— 

hospital  ship I'll 

medical  survey 3'JIO 

ward  management 1457 

home,  nurses 697 

medical  attendance  for  officers  proceeding  imder 3343 

obedience  to,  required 1281 

sheet,  standing 396^ 

shipping 3999 

waiting- 
death  while  on 2435 

health  record  of  officer  on i..;;;:;;:^;::'.!.:'.^ 2302 

Organization,  medical,  for  battle 1811, 1821-1832 

expeditionary  force 1841-1853 

Origin  of  disease  or  injury,  statement  of 825 

Outfits: 

athletic,  provided  for  hospitals 1327 

Hospital  Corps,  insi)€ction  of 1326 

medical.    (See  Medical  outfit.) 

in  icroscopical .    ( See  M  icroscop  ical . ) 

Outline  figure  card,  preparation  of 2101-2105 

Outside  foreman,  hospital,  report  to  executive  surgeon 1542 

Overcrowding  to  be  avoided 2021 

Ozena,  rejection  for 1961, 1981, 2079 

Pacific  coast,  care  of  insane  on 3141-316(5 

Packages.  i)asses  to  remove  from  hospital 1506 

Packet,  first-aid,  contents  of - .'    1002 

Painter,  hospital,  reports  to  executive  surgeon .......A    1542 

Painting  of  hospital  ship,  to  bo  characteristic .':  ...'...■....;'. .    1707 

Palm,  first-aid  care  of  wounds  of 1011 

Panama,  quarantine  jurisdiction  at 2735 

Papers:  .     . 

accompanying  patient  to  hospital .....l^.l; 823 

of  deceased,  disposal  of 241C 

Parades:  •••• 

ambulance  parties—  — 

not  massed  in mmitti 1854 

prepared  for  first-aid .^ 1854 

posts  of  officers  in ." ■ 18W 

swords  to  be  worn  by  surgeons 184,'. 

Paralysis,  rejection  for tana.ii 2079, 2148 

Parasites: 

intestmal,  in  mess  attendants 2117 

intestinal,  rejection  for 10^' 

.skin,  rejection  for • I;<«il,2(t7'.' 

Parasyphilitlc  disease,  method  of  entry 225(' 

Parents,  coilscuI  for  enlistment  of  minors 2004,  aO-V. 

Paresis,  method  of  entering ..:.;;.....  i-.^'.v.'.;.'.. 225si 

Passage,  patients  received  for S56 

Pass-es: 

book,  supplied  l>y  Inu-eau 1'^" 

issued  by  executive  siugoon  of  hospital 131 1 

signed  Ijy  officer  of  t  lie  day 1361 

Passed  assistant  surgeon: 

prolcssioniil  (^xumination  for  promotion  of ^ . . .  .•.-. .i)l,  202 

promotion  of .■...•;.• 162 

Pathological  examinations  by  Naval  Medical  .School 3221 

Pathologloal  specimens  when  forwarded  liy  mail 3220 


INDEX.  •  379 

Patient-s:        ■                                                                                                                        ^^""^'^fh:. 
admission  of,  regulations  relating  to ^^60 


assignment  to  wards . 


ISOf. 

27ir. 

824 

146C 


1367 

attendants  alone  available  for  service  to 1231 

bed,  nvu-se  responsible  for  condition  of 1*^1 

beds  assigned  to ^'  20 

care  and  attention  to ^'^2^ 

care  of— 

by  executive  svugeon 

in  quarantine 

civil  hospital,  procediu-e. 

confinement  in  brig 

convalescent,  make  own  beds : l"2i 

daily  routine - ' ' 

dealings  with,  prohibitions  regarding 434, 970, 1260 

dental,  admission  to  sick  list ■  ■    ^^^^ 

detailed  for  work  in  hospital -  -  •  - ;  1313, 1507 

discharge  of,  regulations  about 1365,  lo24, 152;> 

disinfection  of  clothing  of l^l** 

entries  in  jotu^al  concerning 

fit  for  duty,  report  of '''^]1*^ 

1 990  9901 

health  records  to  accompany '^-^'  ""^ 

hospital- 

apprentice  not  to  play  with '^"^ 

property  returned  by,  on  discharge 1^^' 

,„„  ,  .f  1501-1528 

rules  for .^„, 

ticket  to  accompany 

in  hospital— 

after  sailing  of  ship 

(foreign) • 2201,2205 

three  months,  to  be  surveyed 126;.,  1286, 2948 

insane —  .„  , 

,  1316 

care  of 

health  record  of ^™ 

list  of ■•  •    ^^ 

maintenance  of "' 

medical  ofllcer  to  accompany a  1 V 

money  and  valuables  to  be  safeguarded 1330, 1*64, 1514 

morning  report  of -  -  ■  ■ - ', 

naval,  Red  Cross  and ■ - 36 

not  in  line  of  duty  entry,  procedure -2^- 

not  to  enter  Hospital  Corps '  quarters l"''l ' 

ofB-cer- 


,                                                             1306 

care  of 

of  the  day  to  receive m..-:.:--. 

..      ,                                                                                                                                   1470 

routme  for . 

procedure  on  receipt  of,  in  hospital '^'^^y  f ",' 

quarterly  abstract  of.  Form  F 3922,3936,4121.4131 

received  for  passage '  ' 

health  records  of 

recommended  for  medical  survey ..-;  —  - "^^^ 

refusal  to  take  medicine ■ -  - ■ ;;;...- '' 

...                                                                                                                   4131 

register  of 

entries  by  officer  of  the  day - • '  ^' 

report-s—  ^^^ 

condition  of ,  ,„_ 

J  .,                                                                         ...                                   146/ 

daily ......---... ^^^^ 

m0mmg,0f ....r.  :;;::;. 

return  to  officer  of  the  day....... -.-- .-.■.■.■.■.....■.■.•.•■.- 

to  governor  of  Naval  Home ■ 


380  INDEX. 

Patient-s— Continned.  Paragraph. 

roq\iired  to  wear  uniform 1516 

restricted  to  ward  or  hospital H<j<j 

sick  and  insane,  transportation  of 74 

surveyed 1346 

transfer  of,  to  be  reported 2986 

transferred— 

to  have  health  records 2201 

to  hospital 822-824,1143 

to  hospital,  health  record  accompanies 2229 

to  other  than  naval  hospital 4111, 4121, 4131 

with  venereal  disease,  not  allowed  liberty 1605, 2543 

Pay: 

chief  nurse "25 

continuance  after  capture 4212, 4244 

corps- 
age  of  candidates  for 1965 

visual  acuity  for  admission 1963 

deduction  for  hospital  fund 731,1202,3602,3600,3621,3624,3625,3651 

division,  station  in  battle 1812 

enlisted  men  in  naval  hospitals 1213, 1216 

enlistment  expiring  in  hospital 3004 

gratuity- 
report  of 4131 

to  designated  beneficiary 2401, 2431, 3451 

Hospital  Corps 403, 406, 432 

longevity,  nurses,  calculation  of 722 

loss  of,  for  disease  resulting  from  misconduct 804,832,924 

militia,  checkage  for  haspital  fund 1208 

"  Miscellaneous,"  charges  against 73,  721, 2735, 3400 

Naval  Reserve  Force 131 

Nurse  Corps 602,616,721-732 

of  civil  employees 3400 

officer— 

reports  of  Nurse  Corps 703 

requisitions  on 3543 

to  take  up  accounts  of  nurse "26 

of  the  Navj'— 

appropriation '21 

charges  against 3400 

roll- 
Form  81,  Bureau  of  Supplies  and  Accounts 3962, 3992, 4131 

recapitulation  of 4131 

summary  of 3431 

superintendent  of  Nurse  Corps WB 

Paymaster's  clerk-s: 

Murine  Corps,  physical  examinul  imi  for.. 1^35 

Payments,  under  compensation  act 2106 

Peace  conference.    (See  Hague.) 
Penalty  f  or : 

fal.se  certificate ^'^^ 

omitting  returns  of  contract 3310 

Penslon-s: 

at  ler  20  years'  service 3-54 

allowance  to  naval  hospital  fund 3606, SeSS.SCK^C 

antc-rel>elllon, commencement  of 3714 

applicants ^^ 

examined  by  medical  ollioor 3758 

arising  from  destruction  of "  Maine  " 3 < 45 


INDEX.  381 

Pension-s-Continued.  Paragraph, 

at— 

age  of  62 ^^^^ 

hospitals,  how  paid - 3608,3026 

auxiliary  naval  force 

beneficiaries,  classification  of ^'^■^ 

Bureau ,  information  required  for 2821 

certificate,  commanding  officer  to  sign 3751 

Coast  Guard,  officers  and  men 3/^24 

correspondence  with  Pension  Bureau 3759 

date  of  death  m  "  Jeanette  " 3743 

dependent  relatives ^'42 

disability  bearing  on 2250 

fund.    (See  Fund,  Navy  Pension.) 

honorably  discharged  men.  War  of  Rebellion 3733 

joint  board  of  survey  for -. i ^910 

laws  administered  by  Commissioner  of  Pensions 2822 

legislation,  information  regarding 3761-3797 

limitation  of 3728 

line  of  duty  status 3929 

Medical  Reserve  Corps,  for  physical  disability 3725 

men  in  naval  hospitals ^207 

merchant  marine  service 3^37 

Mexican  War  veterans 3715 

militia,  wounds  incurred  in  service 3^26 

minors — 

of  disabled  officers  and  seamen 3712 

when  entitled  to 3741 

navy,  paid  from  navy  pension  fund 3704 

officers  disabled  prior  to  Mar.  4, 1861 3711 

paid— 

from  navy  pensionfund 3783 

to  naval  hospital  fund ^^^35 

pensioner  ia  Naval  Home,  or  naval  hospital 3752, 3793, 3801-3806 

persons  entitled  to - 3/21 

rate- 
according  to  rank 3731 

dependent  on  rank 3732 

for  specific  disabilities 3734, 3/35 

for  total  disability 3730 

reenlistment  of  pensioner .  -. : 3795 

relation  of  ILae  of  duty  to 2841-2852 

report  of  death  as  evidence  for 2409, 2431, 2817, 3755 

service,  to  disabled  after  10  years'  service 3753 

sick — 

furlough,  status  when  on 3729 

leave,  statiis  when  on 3729 

status  of  midshipmen 2836 

veteran  furlough,  status  when  on 3729 

widows — 

of  officers  and  seamen  disabled 3712 

of  those  lost  ia  wreck  of  "  Ashuelot " 3744 

when  entitled  to 3741 

Pensioners: 

biennial  examination  of ^^ 

hospitals,  u3structions  regarding 1531-1535, 3752, 3793, 3801-3806 

Naval  Home 1535,1633,3752,3793,3801-3800 

Permanent  appolntment-s: 

chief  pharmacist's  mate ^^2 

hospital  apprentice,  first  class ^^>  523 


382  INDEX. 

Permission:  Paragrapb. 

\o  leave  hospital,  by  executive  surgeou 1310 

to  leave  ship ■.•.•■■.■••.:•.•.:••: ^^ 

Personal  memorandum  for  surgeon  general ..,.>.,., ,^< 4121,4131 

Personnel  of  surgeon's  division ■ 870 

Petioleum,  use  of,  as  insecticide 2781 

Petty  officers,  probationary  time  in  hospital 1264 

Pbarmacist-s: 

acts  as  oflicer  of  the  day 1294, 1333 

appointment  of r -yrn-i-  fcnr?.')''  •  ■ : r  —  •.'j 401, 442 

bill  book,  instructions  oonceming -  •  -  .-•..-, -- -. 1385-1397 

classification  of -  - 441 

clerical  work  supervised  by 1371, 1372 

commissary  department  of  hospital 1371, 1373 

commissary  ledger,  instructions  concerning 1411-1418 

correspondence  supervised  by .- 1371 

duties  of -• ..■,.:„.... ^j^^,^yi-P c;w..,  443-445,1371-1425 

examination  for ; 504 

instruction  of  Hospital  Corps -. 1371, 1375 

meals  Inspected  by — 1325 

precedence  of .-.-.-  -.-  -  '• -H-r  •  vi-h :  ---^H-f?--  •  •  •  r  •  -  -  -- 441 

promotion  to  chief  pharmacist .;.,... 407, 501 

property  accoimting -  -  -. v ■■•,■■■ - 1374 

ijualifications  for 503 

rank  of 441 

statement  of  cost  of  maintenance 1421-1425 

vacancies  filled  from  chief  phiu-macist's  mate 502 

Pharmacist's  mates,  chief: 
appointment- 
acting -■ ,--•• -T 511,513 

permanent oil, 452 

enlistment  as ■  •  • ■  •'■  ■ 451 

examination  for  promotion  to 490,512,513,514,3964 

instruction  of  Hospital  Corps  by - 455 

marines  not  assigned  as —  ■ 453 

of  the  day,  duties  of 1431-1435 

permanent  appointment 452 

promotion  to  pharmacist W7 

qualifications  for - 511 

rank  and  precedence 401,437 

re  ;ponsibllity  for  stores 454 

stall  potty  olficer  with  brigade  surgeon •. 1161 

Pharmacist's  mates,  first  class: 

appointment 464 

duties 426 

examination ''"'n 'i 520-521 

pay ...:...'..,,.^..;. 403,406 

promotion ■.'......;. . 512, 513, 521 ,3954 

rank  ami  precedence .^^.^^^^..f, 401,403,461 

Pharmacist's  mates,  second  class: 

ajipointment ; r : 464 

duties •- -  •  •  • •  •  •  •  • 425 

examina  t  ion ,y.^ , , ,, ,  |. 522 

pay ..:...:...:::..:;;.:: : 403,406 

promotion 520, 521 

rank  and  pr^edence '. 401,403,461 

Pharmacist's  mates,  third  class: 

,iI)pointment 464 

.liilir",  426 


INDEX.  383 

Phaimacist's  mates,  third  class— Continued.  Paragraph. 

examination 523 

pay 403,406 

promotion 520, 522, 523 

rank  and  precedence 401,403,461 

Pharmacy,  instraction in j,,^,.„, 1375 

Phenol: 

crade,  as  insecticide 2781 

diiinfection  by 2753, 2705 

Philadelphia  Naval  Hospital: 

patients  report  to  governor  of  Naval  Home 1214 

Phimosis,  rejection  for 1981 

Physical: 

ability,  employees,  rating  of 2145-2155 

defects- 
curable  by  operation 1985, 2081 

entered  in  report  of  rejection 2081 

found  on  reenlistment ..'....',.-.'----•-»•>.---' 2004 

waiver  of ^  ..... .  2029, 2052, 2064 

disability- 
procedure  upon  linding 173 

record  made  ou  enlistment 2013, 2078 

disqualifications  for  enlistment,  list  of 2079 

efficiency,  standard  to  be  high , 1992 

examination.    {See  Examination,  physical.) 
exercise- 
examination  for 908 

periodical,  health  records ,.^j_, 2217, 2234 

requirements  for  special  ratings 2067 

unfitness,  professional  examination  not  given  when  lound —   .   i925 

Physiognomy  of  applicant  for  enlistment , 2068 

Physiology,  department  of 938 

Pioneers,  reinlorcement  of  stretchermen  from ^^.^ 1848 

Pillows,  disinfection  of .-,....:.....,  j,,.j,.,.i^ 2767 

Pilot,  detention  for  quarantinable  disease 2734 

Place  of: 

birth,  entered  on  health  record 2241 

enlistment,  entered  on  health  record :  jft-r -^ 2241 

Plague : 

y,     disinfection  after 2763, 2781 

quarantine  for 2731 

Plaster  of  Paris  for  rat  destruction ^i^■,,.,,.^^^y.:^..f..■. 2781 

Poisoning,  lead,  prevention  of 2618 

Poisons: 

caro  of 1335 

classification  of 2361 

dispensing  of 1335 

kept  under  lock  and  key 1463 

Polypi: 

e.xamination  for 2061 

rejection  for 1961, 1981, 2079 

Port-s: 

arrival  in,  with  quarantinable  disease 2714 

foreign,  report  to  Oflfice  of  Naval  Intelligence 2566, 2655, 2661 

health  of 2.516 

to  be  reported 2632, 2655 

infected — 

anchorage  in 2523 

health  of,  to  be  ascertained 2607 

to  be  avoided 2606 


384  INDEX. 

Port-s— Continued.  Paragraph. 

officer  always  on  duty  when  in 1734 

quartermaster  always  on  duty  when  in 1734 

sanitar>-  conditions  of 813, 828,2562 

West  Indian,  reports  of  epidemics  in 2567 

Postage,  charged  against  "Pay,  miscellaneous" 3400 

Post-mortem  examinations,  performance  of 2443 

Posts  of  officers  in  parades,  drills,  etc 1854 

Pouch,  Hospital  Corps,  carried  by  hospital  corpsman 1846, 1864 

Powder  division,  Hospital  Corps  not  a  part  of 423,870 

Pratique : 

no  communication  with  shore  until  granted 2713 

obtaining  of 2741 

Precedence  of: 

chief  pharmacists 441 

chief  pharmacist's  mates 401,437 

hospital — 

apprentice,  first  and  second  class 401,461 

corps 437 

pharmacist 441 

pharmacist's  mates,  first,  second,  and  third  class 401,461 

Preliminary  physical  examination  for  Naval  Academy 1984-1986 

Preparation  of  food 851 

Prescription  book 9<«,  1366,3525 

President,  officers  appointed  by 1902 

Prints.    (See  Finger  prints.) 
Prison-s: 

duties  of  medical  officer  at 937 

report  on 898,2532,2597 

sanitation  of 2596 

ships,  duties  of  medical  officers  on 937 

Prisoner-s: 

cells  for 3653 

discharged,  transportation  of 3611,3658 

general  court-martial,  not  sent  to  Las  Animas .I'.'l'. i'.'l 1267 

injuries  in  line  of  duty 2831 

inspection  of 854, 2672 

medical  survey  of 2947 . 

physical  examination  of 2114 

visited  by  officer  of  the  day 1368 

Probationary  service 672 

Proceedings,  court-martial,  medical  certificate  on 895 

Professional  examination: 

failure  to  pass 166 

for  promotion 164, 172 

of  assistant  surgeon  for  promotion 191-193 

of  medical  inspector  for  promotion 221 

of  passed  assistant  surgeon  for  promotion 201-202 

of  surgeon  for  promotion 211 

Professor  of  mathematics,  appointment  of 1906 

Promotion: 

candidates  for — 

merit  roll  of 1944 

statement  by 1958 

eligibility  for .'      177 

examinations  lor 164, 165, 166 

fitness  for,  onus  ol  establishment , 178 

heal Ih  record  on .....t!.'....... 180 

in  Hospital  Corps i:.!. ....:...!.: 429,463,486 

report  of 488 


INDEX.  385 

Promotion-Continued.  "'"'■'    '  P'aragraph. 

laws  relating  to ^^'Wf^ 

merit  roll  of  candidates  for 

of  assistant  surgeon,  prolessional  examination  for 191-193 

^®Tr,  .  320,34;^347 

dental  corps ' 

disability  in  line  of  duty '■ ■ "^^2 

examination  on  foreign  stations "^ 

^  ,,,     ,  2232,2202,2303 

health  record '        ' 

hearing,  requirements 

hearing,  standard  of 

Marine  Corps,  physical  examination  for ^^^ 

Navy,  physical  examination  for 

notifies  medical  olficer 

physical  disabiUty  in  line  of  duty |^ 

physical  examination  required ° 

physical  qualification  for  duty  at  sea ^ 

procedure  when  rejected  physically - ■-    J°^ 

rejected  for,  to  be  retired ■ 'Ig" 

teeth  requirements ■ i  959  19^ 

visual  acuity  required ; ' 

wounds  in  line  of  duty • 

of  hospital  apprentice,  first  class " 

of  passed  assistant  surgeon 

of  pharmacist ' " ' ' 

professional  examination  of—  191-193 

assistant  surgeon  for " 

medical  inspector  for - 201-202 

passed  assistant  surgeon  for 

surgeon  for " 

suspension  from . 

to  cliief  pharmacist 512-514 

to  chief  pharmacist's  mate . 

to  hospital  apprentice,  first  class • '^^  ^^ 

to  pharmacist ' 

Property.    (Se.  Stores,  Supplies.)  3504,3521-3525 


accountability 

1467 


cards,  kept  by  ward  nurse 

hospitals gg^j 

instructions  relating  to 

.     ,         ..    ,  lo74 

accountmg  in  hospitals 

book,  kept  by—  -^^ 

'^"^®-" ' 1342,1346 

ward  officer 

breakage  of,  reported  by  nurse 

dental—  jq27 

'^^'^'^[■y- ;::;:;;;'34o,io28 

requisitions  for ' 

responsibility  for 

returns  of 965  1027 

expended,  accountability  for 

expenditure  of,  in  hospital 

hospital-  3gj3 

proceeds  of  sale  of 

returned  on  discharge ^qoo  '  ^935  Um  4131 

inventory  of,  Forms  D  and  Da 3922,3935,4121,4131 

of  patient  in  brig,  care  of 

98601°— 17 ^25 


386  INDEX. 

Property-Continued.  Paragraph. 

private,  removal  from  captured  vessel 4217,4310 

returns  of "^^'^ 

from  slaps 1144,3524 

survevs  of ^^^^ 

forms  for ■ 3922,3934,4121 

in  hospitals ■ ^^^^ 

upkeep  of,  in  hospitals *^^^ 

Prophylaxis.    {See  Tj-phoid  and  venereal . ) 

Proposals,  advertisement  for ^302 

Proprietary  articles  to  be  avoided - •  •■    ^379 

Prosthetic  procedures,  not  duty  of  dental  ofRcer ..^ 1033 

Provisions: 

extra  on  open  purchase ■  - 861 

for  crew,  inspection  of :  •  - "^^O-  ^^>  25''*>  25"0 

for  hospital,  inspection  of ■ 1^®*>  2582 

inspection  of,  entered  in  journal ..,^.,..,.  .,r-p-  ,(>- '-'-  :-T-.r.v :-. ^'^^ 

Nav^-,  appropriation  for • ...,i-._.,,.i^..f, „-.- '21 

Psychopathic  wards,  care  of ^'^^^ 

Public  bill-s: 

afloat 3401-3403 

approval  of ' 3^- 

disposition  of • ^-^ 

entered  in  bill  book ••  —  --• 1392.1403 

foreign  stations •  -  • -  •  •  •  • ^^^ 

for  funeral  expenses ■  - -u  i^vr -rirr -^  ■'••■• 

Forms  5  and  5a,  6  and  6a -;.t:- -^j- r-.-i- ^'^^ 

instructions  concemmg - -  ■  • -  -  -.  -  —  -.r '  ■  ■  • oo<  i  •>  i-- 

medical  attendance '■rt-'-:-r.;r- ^^^ 

....; .........;.. 3331 

3365 


prepared  without  delay, 
recruiting  duty 


2707 
24 


PubUc  biU-s: 

special  exigency— 

to  bo  avoided "^^^ 

use  of ^^^ 

Public  Health  Service: 

admission  to  Army  and  Navy  Hospital •  •  • -  -,    ^*^^ 

diseases  considered  quarantinablc  by •-•?-■•    ^^^ 

dismfccting  stations  of ^^^ 

([uarantine  duties  of 

PubUc  works: 

estimate  for  appropriations  for -  •  •  •  •.■.■.•.>t-*ftr''"*' 

report  of,  from  hospitals '•^' 

Punishment: 

for  offenses  in  hospital 1277, 12«5, 1363 

of  dental  ofTicers .,,.^., 1022 

Purchase: 

of mclical stores .■-••, «)u, joo 

of  naval  hospital ••■"*.■,■■.•.■■  

of  naval  supplies "^ 

without  advertising •  •  ••.•.•.••.•.■.■ '  ■  -.Ui't' *'■ '    ^^ 

Pyrethrum,  disinfection  by •  - •  •  •  ,T  i -  -r^ 

Qualiflcatlons  of  pharmacists .•••,;.•••?  firrr 

Quallflcation  report  of  hospital  corps  candidates  for  promotion 39*4 

Quarantinable  diseases: 

arrivalin  i>ort  will' .••.•.••.•.•■•■••. '„ 

caro  of  patients  with •  •  ■  •  •  •  •  •  •  • ' •  ••  '.* ' ".'Af  "  '' 

flag  when  at  sea  with •••••  0-31  ',-3!^ 

l^-: '• :.::. '^ 

report  of 


INDEX.  387 

Quarantine :  Paragraph. 

boarding  of  vessels  subject  to iJll'W}?: 2717 

camp 2621 

'     duties  of  Tublic  Health  Service 2707 

expenses ..-. ii." 73,2741,2744 

flag,  hoisted  while  at  sea 2710 

inspection,  vessels  of  Navy  subject  to -    2732 

instructions  relating  to 2711-2722 

jurisdiction  at  Colon  and  Panama 2735 

laws  relating  to -  2701-2708 

regulations  to  be  observed 2711 

Quartering  of  troops,  exemption  from 4206 

Quarters: 

for  Red  Cross  peisonnel , 4360 

furniture,  appropriation  for 1397 

general.    {See  General  quarters.) 
hospital- 
apprentice,  assigimient  of 14^1 

corps,  patients  not  to  enter 1517 

corps,  supervision  of 1431 

medical  officer  notified  of  disease  in 2592 

nurses 751-753 

commutation  of 618, 7.53 

furniture  supplied  by  bureau 752 

Government  property  in 1445 

linen  supplied  by  bureau 752 

rent  of ■ 721 

oflicer-s — 

disbursement  for 74 

of  the  day's 1361 

rental  of,  charge  against  "Pay  of  the  Navy" 3400 

Quartermaster: 

always  on  duty  in  port 1734 

regimental,  transportation  provided  by 1850 

Rank: 

examination  for,  instead  of  grade -■•      169 

of— 

chiefs  of  bureaus 6 

chiefs  of  bureaus,  retired -         7 

chief  pharmacists ■, 441 

Dental  Corps  officers 322 

hospital  apprentice,  first  and  second  class 461 

medical  officer 102 

;  when  retired 103, 104, 165 

;  Medical  Reserve  Corps  officers 231 

noted  on  admission  report 1467 

officer  retired  for  physical  disability 1909, 1941 

pharmacist -14) 

when  examination  is  delayed 161 

pension  rate  according  to 37.30, 3732 

relative,  in  the  Navy 3731 

Rating-s: 

abbreviations  for 2241 

change  of,  in  Hospital  Corps,  report -187 

entered  on- 
descriptive  list 2103 

health  record - 2241 

noted  on  admission  report 1-167 

of  applicant  for  appoint  ment  as  laborer 2145-2154 

special,  physique  of  applicant  for 2067 


388  INDEX. 

Ration-s:  Paragraph. 

allowance  of,  to  Naval  Hospital 3^^^'  '^^'^ 

commutation  of,  at  Army  and  Navy  Hospital ^615 

deduction  from  pay  of  persons  in  hospil  al  for 3622 

memoranda  for  commissary  ledger 3965 

notice — 

admission.  Form  S 1276, 3013, 3*22,3948, 4131 

discharge.  Form  T 1276,3013,3*22,3949,4131 

Nurse  Corps 741,742,1615 

report  on -""^^ 


value  of. 


3652 


Kats,  destruction  of 2763,2781 

Keading,  lights  supplied  for 2540 

Readmission,  abbreviation  used  for - - 22»4 

Rebellioa,  War  of,  pensions  of  honorably  discharged  men ii...-:..i. 3.33 

Keceipt-s: 

and  e.xpenditure  voucher 3966 

for  antito.xins,  sera,  etc 3563 

for  medical  stores 868, 3£01,3513^3515, 3519 

instructions  regarding 3511 

of  stores  entered  in  journal 2318 

Beceiving  ship: 

domicile  between  enlistments ^^33 

personal  memorandum  for  Surgeon  General 4121 

reexamination  of  recruits  on 2030 

requisitions  from ^'' 3^31, 3541 

Kecommendations.  sanitary,  to  commanding  oflicer 2563 

Becord-s: 

accuracy  of -. -"^ 

burial 4131 

cemetery,  supervision  of ^319 

degree  of  disability  to  be  stated  in 3761 

denial— 

in  health  record 2267-2271 

treatments ■. I(r26, 103^1037 

enlistment,  medical  oflicer  makes  entries  on 2059,2077 

finger  print,  instructions  concerning 2091-2096 

gunnery,  vision  examination  entered  on 2111 

health.    (Sec  Health  record.) 

identification,  to  be  prepared 2093-2096 

medical*,  of  expeditionary  force 1*^ 

l''>54 

neatness  of 

bureaus,  custody  of * 

dental  treatment  in  health  record ^^^i  3922 

e.xammations _  ^ 

inspect  ion  of  provisions  and  supplies ^284 

persons  dying  in  naval  service 2431 

physical  disability  to  be  made  on  enlistment •....».'. 2013 

proceedings  of  board  of  inquest •  •  •  ■' 2424 

treatment,  dental  olhcer  to  keep ^    "^^"^ 

physical  txaminatiou,  for  monthly  physical  exorcise 2217,2234 

86rvicc~~~ 

entries  in 948,2017,2028,2077,2081.2096,2992 

of  Hospital  (  orps *"  Vro 

waivers  entered  on 

sick,  of  nurses,  kept  by  chief  nurse ^**^ 

vorificaiion  of,  on  going  into oommLsslou .■.■if4Vi..'j:..i'j.........      842 

Recorder,  sick-bay,  liospil;d  apprentice  detailed  as ;...:..•.: 4'3 


INDEl. 


389 


Paragraph. 
3132 

Recovery  of  insane  person,  procedure ^^27 

Recreation  time  to  bo  provided 

Kecniit-s:  933,941-932,2011/2088 

examination  of 2081 

oath  of  allegiance  taken  hy ' ' ' " ' g^ 

reexamination  of 2081 

statement  under  oath 2024 

surveyed,  medical  officer  responsible  for ^^^  2033 

typhoid  prophylaxis  to 951, 2031, 2032',  2086 

vaccination  of 1278 

Recruiting  duty,  hospitals 33^5 

recruiting  duty,  medical  attendance  for  men  on 

Recruiting  station:  922 

duties  of  medical  officer  at ! '2051,3922,3951,4121,4131 

Form  X  prepared  at '    2075 

Red  blindness,  detection  of 

Red  Cross  (see  Aid  societies):  433I 

authority  for  cooperation  v/ith  Navy 1807 

cooperation  in  war 

flag—  1868 

brigade  hospital  designated  by ^g^^ 

displayed  by  sanitary  formations ^gg, 

dressing  station  designated  by gg^ 

hospital  boat  to  carry _  _    2502 

part  of  sanitary  service  of  naval  forces .'.'.!";...  4341-4360 

regulations  relating  to 

Reenlistment:  2054 

Army  service  not  counted  as 2015 

authorized  if  physically  qualified - ^oie  2064 

continuous-service  man ,  physical  disqualifications  for ■■•-■••  ^^^^'^  ^^ 

health  records,  procedure  with ' ' " ' ' '  ggg^ 

Marine  Corps  service  counted  as 2019 

Marines  with  physical  disability 2054 

Navy  service  counted  as 3795 

pensioner,  procedure 2064 

physical  defects  found  on ' ' ' ' ' 20S7 

typhoid  prophylactic  required 20S6 

vaccination  required 2064 

waiver  recommended *■ " 131  132 

Reenrollment  in  Naval  Reserve  Force 

Refuse :  2621 

disposal  of I735 

regulations  concerning 

Regimental:  1862,1864 

aid  stations Ig63 

ambulance  party  in  engagement jg^2 

commander  selects  regimental  surgeon ^g^^ 

quartermaster,  transportation  provided  by 1854 

stafl,  post  of,  in  parades,  etc 

surgeon—  1843 

duties  of 1854 

post  of,  in  parades,  etc jg^^ 

Segiment,  naval,  organization  of 

Register  of:  1445 

nurses,  chief  nurse  to  keep ; ^j31 

patients 1363 

entries  by  officer  of  day 


390  INDEX. 

Registration:  Paragraph. 

i>y  ned  Cross,  application  for • ^^'' 

of  imrses  required 643 

Regulation-s: 

for  government  of  hospitals 1239, 1282 

harbor,  hospital  ship  I  o  observe -..,.... 2585 

hyf;ionic,  sliips ' - 891 

qiianintine,  to  be  observed 2711 

Reinforcement  of  stretchermen,  during  engagement 1848 

Rejection: 
iipplicant— 

for  employment,  causes  for 2124,2154 

for  enlistment,  causes  for l^>i  1,2001,2079 

roport—  ' 

instructions  concerning .-.-.-.- 2081 

waivers  requested  in 2064 

Relatives,  dependent,  pensions  for 3742 

Relief  of  wounded _: 818 

Religion,  entered  on: 

a'Jtnission  report l-***" 

hc;ilth  record 2241 

Religious  stafl  of  captured  vessel:  .       i  :    •• 

continue  duties ^1^ 

neutrality  of 4217,4278,4310 

Remains: 

care  in  preparation  of 3450 

diiinlerring,  exjwnses  of 3437, 3443 

expenses  of  transportation 2405, 3400, 3433-343.5, 3i37,344&-3400 

request  for  shipment  of 3455 

transportation  of,  appropriation  for 72 

Removal  of  Nurse  Corps .^,(.,._.Hf,.-.,iiJr; •'—- '^^^ 

Rendezvous,  reexamination  of  recruits  from  — 950 

Rent,  quarters: 

charge  against  "  Pay  of  the  Navy    ...  3400 

Nurse  Corps .•••'r-OTm^' ^^^ 

Repairs,  urgent,  for  sanitary  reasons  —  •  •  -.r"*-- ^^* 

Report-s: 
admission- 
made  by  nurse ,■ l**^' 

of  officer  as  patient 4131 

or  retention  of  supernumeraries 4131 

aimual *^^^ 

recommendations  on  special  subjects • 41^4 

Wanks  necessary  for .•.•.•.•.•.: y *^^' 

brigs : 898 

cases  of  tuberculosis .•-- 4002 

casualties  In  action — .-•'■•::••• ^^l^ 

changes  in  nospltal  Corps 3053,4121 

concealed  diseases ^     ^*' 

concerning  nurses <01-70S 

condition  of  insane  in  St.  Elizabeths  Ilospltal. 3131 

conduct 3983 

accompanies  patient  to  hospital .••-• 3006 

supervised  by  ofTicor  of  the  day ••.-.If  ^"*'''' 

confliiomcnt  spaces 89S 

contagions  diseases ' 828. 2513, 2tl32, 4002 

death .•  ■        :::....:.....::: S25,ii4i.39i2 

evidence  for  claim  for  pension .  2M . ,  3/  55 

KormN 3923,3944,4121,4131 


14G7 
4131 


INDEX.  391 

Report-s-Continued.  Paragraph. 

death — 

T"''"' ""f. 

of  msaue 

preparation  of 2401-2443 

ifental — 

on  Form  K ' 2388 

operations,  Form  K ^^22 

worlc,  statistical - ^"'^ ' 

disability  in  absence  of  medical  officer 2215 

discharge- 
made  by  nurse 

of  officer  as  patient 

disease— 

among  personnel ^^^'  2*^2 

contagious,  on  ship 250 

epideL.. - 828,1147 

infectious,  on  ship ■"^ 

in  fleet  by  commander  in  chief 2513 

division  surgeon  to  division  commander 

duplicates  to  be  noted ■ ^  ^ 

efflciencv,  Hospital  Corps 491,1153,1288,3903,4121,4131 

epidemic 4121,4131 

in  West  Indian  ports 2567 

examination- 
hospital  apprentice,  first  class ■**" 

Hospital  corps.... '""'"'^''tZ 

executive  officer's,after  battle ;; -179:3981,  131 

fitness ' 

fleetsurgeon,  approval  of 

foreign  naval  medical  establishments 2654 

from  division  surgeon - 

fleet  surgeon 

hospitals,  list  of 

hospital  ships,  list  of ' .•  ■ 

medical  officer  afloat ^2 

from  medical  officer  in  command  of  hospital  ship i '«l 

navy  yards,  list  of • 

stations,  list  of _ " "     ^ 

funeral  expenses 2407, 4131 

general  sanitary „.• 

,       , , ,      ,         .  2032, 2650 

health  of  port ' 

Hospital  Corps,  movements  of ■ }°t 

illness  considered  to  be  typhoid 2612 


infectious  or  contagious  diseases  on  ship 

...  ,  2171,2175 

injury  to  employee 


,       ..  ,  4111 

hospital ^^  j^ 

hospital  ship ■ 

medical  department  of  ships hiq',;,,  isnR 

killed  and  wounded ■ ;;;„""  ^ ;':;!' 1,^ 

...... 1805,3922,3941,4111,4121 

m  battle '  iiro 

laboratory  examinations "I* 

, .         .  816 

malmgermg 

Medical  Department,  instructions  regarding ocq- 

medical  officer  of  prison ; "         ' 

Wicalsurvev  1142,2903,2931-2937,3910,3922,3943,4121,4131 

^loninHnPt        1242, 1305, 2818, 2820  3915, 3922, 3972, 4121, 4131 

misconduct 3967,4121,4131 

raommg,  of  patients 


392  INDEX. 

Report-s— Continued.  Paragraph. 

mortiiarj',  preparation  of 2440 

night,  in  hospital 13&4 

nurse- 
confidential  illness  of p. , 70C 

corp>s,  efTjciency <131 

illness  of 711 

^    ofBcer's— 

after  battle 1S15 

discharged  from  hospital 1221 

discharged  to  Naval  Home 1221 

required  to  submit 4107 

transferred  to  hospitals 1221 

official,  submitted  by  nurses 1444 

operations,  Form  P 3922, 3946, 4121 ,  4131 

patients- 
condition  of 1284 

daily 1467 

in  civil  hospitals 824 

morning 3967, 4i2l,  4131 

prisons 898, 2532 

public  works,  from  hospital 12D1 

quarantinable  disease 2733 

reduced  to  requirements  of  service 4103 

rejection- 
instructions  concerning 20S5 

waiver  requested  on 2064 

returnable  through  fleet  surgeon 1141-1154 

sanitary 814, 867, 1138, 2W1-2655 

annual,  from  hospitals 2635, 2651, 4131 

condition  of  buildings 2591 

condition  of  fleet,  by  commander  in  chief 2514 

condition  of  port 2562 

entered  in  journal 2318 

fleet  surgeon 2633 

hospitals ■  - 1259 

inspection  of  ships ..^i,...,,^  .,.,.[,,^..j^.,„..^ 4111 

monthly,  from  stations .., 2631,2652,4131 

ships 867,1138,1146,2632,2653,4121 

shore  stations 969 

yearly,  from  hospitals 2584 

yearly,  from  ships 2574 

yearly,  from  stations ....,..,. 2503, 2634, 2652, 4131 

(   sick—  ,     ,( 

daily 847, 933, 9(>1, 3908 

morning 13 18, 4121, 4131 

statistical : 1149, 1256, 2371-2391 ,  3909, 3922,3940,4121, 4131 

weekly 1145. 1238, 3907, 3922,3939, 4131 

submitted  by  fleet  surgeon  to  commander  in  chief 1140 

subsistence  of  Ilospital  Corps ^,..v,.,.... 39f>4,4131 

termination  of  disability 2175 

to  Office  of  Naval  Intelligence 2;V.i;.  2(;55, 2ail 

to  officer  of  the  day rr:  ■*  •  —    ^^^ 

transfer  with  venereal  di??i?c< ...    2110 

use  of— 

harbor  water  on  uci  V'02 

intoxicants  or  drugs •.-.••- •-• .•.-.•.•.■.•.•;;:  ■.■-.•, ^^ 

venereal  prophylaxis 1150 

witnesses  of  accidents 3816,3756 


INDEX.  393 

Report-s— Continued.  Paragraph, 

work — 

done  in  laboratory 1351 

done  in  special  wards 1349 

Reporting  for  duty  entered  in  journal 1362 

Request-s: 
or— 

blank  forms,  Form  O 3922,3945,4121,4131 

books  and  blanks 3991,4131 

leave  of  absence,  blank  for 3982 

medical  survey.  Form  L 2921-2925,3922,3942,4121,4131 

shipment  of  remains - 3455 

transfer  of  labor 3994,4131 

olBcial,  submitted  by  nurses 1444 

telephone,  for  extension  of  leave 1503 

Reqnlsition-s: 

articles  not  on  supply  table 3553 

bidders  named  on 3378  . 

copies  to  be  filed 3376 

cost  entered  on 3378 

disposition  of 3333 

•    emergency i 3393 

entered  in— 

bill  book 1385 

journal 2318 

or— 

bacteriological  supplies 3556 

dental  property  and  supplies 340, 1028, 1039 

medical  stores 859,3532,3901 

microscopes  and  microscopical  supplies 3555 

miscellaneous  expenses,  hospitals 3382 

miscellaneous  supplies 3421 ,  3422 

proprietary  articles,  to  be  avoided 3379 

transportation  of  medical  supplies 1850 

Form— 

B 3922, 3931, 4121, 4131 

Ba 3922, 3932 

1 3922, 4131 

2 392 

4 3933, 4121, 4131 

from— 

fleet  siu-geon ; 1132 

hospitals 1314, 3531, 3541 

receiving  ships 3531, 3541 

ships 3396, 3531, 3541, 3548, 3554 

ships  at  navy  yards 3324, 3327, 3548 

stations ...:...,. ..^. 3396,3531,3541 

yards ■ ....'J^^^f^.,....., 3531,3541 

instructions  relating  to ,. . ..^.. ,. j.^,.  ..^ ..,, -,.' " " ' ' 3541-3548 

making  of ...,,..^ ....,- 3375-3383 

on—  , 

naval  medical  supply  depots 3395, 3411-3414 

*  .  other  departments  of  ship 3323 

pay  officer 3543 

open-purchase - 1416 

limited  to  $500 3373 

on  ships ■ ; 3325, 3326 

on  shore ■•;<■<"■)!;"•  V '    ^^^^ 

shipped,  summary  of - 4131 


.'^94  INDEX. 

Requisltion-s— Continued.  Paragraph. 

small  stores,  preparation  of 1527 

special,  Form  Ba ----.. R59, 3922, 3932, 4131 

standard  specifications  used - -  -  -r  -  -.-  ■■■■ 3377 

.,tx,b .'.-..'.' 338.5,3993,4131 

Rescue  breathing  apparatus 1821 

Rescue  of  civilians 2^*46 

Reserve : 

hospital,  base  hospital  acts  as -  -  - 1869 

nurses 601,621,781-784 

ships  in.    (See  Ships  in  reserve.) 
Reserve.    (See  Naval  Reserve  Force.) 
Responsibility  (or: 

loss  of  stores ■'■->!  Yo'  h'' ^^' 

value  of  surgical  instruments 3906 

Kesuscltatlon  of  apparently  drowned 1012, 1821 

Retainer  pay  for  Naval  Reserve  Force 131 

Retired : 

enlisted  men.  Marine  Corps,  in  hospital 1534 

list,  rank  of— 

chiefs  of  bureaus " . 

medical  olHcers : l^i  1^^' 

oihcers  and  men- 
death  report  of 2437 

health  records  for 2246 

Retirement:  '    • .  j,   ' 

medical  officer  notified  of r    2302 

ofTicer- 

examination  for,  health  record 230:J,  2304 

physically  disqualified 1^^ 

rejected  for  promotion 1909,1912,1941 

relation  to  line  of  dut  y 2802 

Returns : 

fleet  surgeon's  approval  of H-^ 

hospital,  supervised  by  executive  surgeon 1314 

medical  department,  iastructioas  regarding 4101-4131 

monthly,  of  nurses '^l-^l 

of- 

contract,  filed  in  returas  office • 3312 

contract,  i)enalt y  for  omitting ::..>;:.;:....;...:...    3310 

dental  property 3*^ 

medical  stores,  Form  V 3922,3950,4131 

nurses '01-703 

property 3902 

property  from  ships 1144,3524 

periodical,  how  authorized *102 

reduced  to  requirements  of  service 'l^'-' 

ships  separated  from  commander  in  chief '  I''*'' 

revenue  cutter  service.    (Sec  Coast  Guard.) 
Revenue  Cutter  Service.    (See  Coast  O  uard. ) 

RovlowluK  officer,  post  of,  in  parades,  etc ^"^ 

Reviews: 

ambiilance  i)arlies  not  massed  In l'*54 

posts  of  ofTlcers  in ^^^ 

Rheumatism,  rejection  for ■^'^ 

Rictets,  rejection  for ..■.......;..'.■....  -J"' •' 

Rlnes,  relaxed  Inguinal,  not  cause  for  rejection '-*''*' 

Roaches,  fle^lructlon  of :..:.:. 


2781 


INDEX.  395 

SoU:  Paragraph. 

bedding  and  clothing,  expeditionary  force .......: 1847 

merit,  of  candidates  forwarded  to  bureati 1944 

pay.    {See  Pay  roll.) 

Room,  operating,  care  of .-..-,--, 1315, 1350, 14.50 

Routine:  

daily—  

of  ward 1470 

sick  oflRcers' 1491 

modification  of 2520 

Rubber,  disinfection  of 2769 

Rules  for: 

guidance  of  attendants 1343 

patients  in  hospital :-  1501-1528 

Safe,  money  and  valuables  placed  in -  —  -  -  - ;  - -  —    1514 

Sailors,  honorably  discharged,  preference  of 2150 

St.  Elizabeths  Hospital,  for  insane 3102, 3109, 3111, 3130, 

admission  to 3121-3122,3123,3129,3124,3137 

death  in 2438,3136 

laws  relatmg  to - 3101-3111 

medical  certificate  for 4001 

papers  required  for  admission 3137 

Sale  of : 

hospital  property,  proceeds  of 3013 

stores  to  nurses 732 

Salutes  by  staff 1854(d) 

Salvarsan,  evidences  of  administration  of 2061 

Sanitarium  Co.,  Portland,  Oreg ^ 3164 

Sanitary : 

base.  Red  Cross  service  at 4352 

condition-s —  . 

boat  trips  dependent  on 2535 

liberty  dependent  on 2535 

of  ports 813,828,2562 

of  ships 891 

data  for  report  to  Office  of  Naval  Intelligence 2566, 2655, 2661 

directions  for  camp 2621 

duties  of— 

commander  in  chief 2511-2525 

commanding  officer -  •  ■ ■  ■  2.531-2546 

fleet  surgeon 2551 

Medical  Department 2501 

medical  officer  of  hospital '."A-it.i.-in.-.x'.^.i.'i :  J^^  *.  2581-2584 

medical  officer  of  hospital  ship -  -  - 2581-2586 

medical  officer  of  ship 2.561-2578, 2601-2618 

formation- 
display  Red  Cross  flag 1845 

neutrality  of 4240 

protection  of 4237-4239 

inspection— 

by  fleet  surgeon 1133 

of  ships,  report  of 4111 

personnel  directed  by  brigade  surgeon 1842 

precautions  in  unhealthy  stations 2515 

recommendations  to  commanding  officer 2563 

report -s.    (See  Report,  sanitary.) 
service— 

emblem-s  for 4249-4254 

Red  Cross  a  part  of 2502 

suggestions 814 


396  INDEX. 

Sanitation:  Paragraph. 

field ,  medical  department  duties  in 1861 

instruction  in 1375 

of  marine  barracks 2594 

of  prisoners 2596 

Saicocele,  rejection  for 1961, 1981, 2079 

Savage  enemy,  ambulance  party  armed  against 1845 

Scalds,  dressings  for  in  battle  stations 1821 

Scales,  not  provided.    {Sec  2096  note  ad  finem. ) 

Scalp  wounds,  first-aid  care  of 1010 

Scar-s: 

entered  in  descriptive  list 5103, 2104 

examination  for 2061 

vaccination,  character  of 2086 

Schedule  of  bills  of  lading 3996 

School-s: 

for  Dental  Corps,  under  control  of  bureau .'j^.'i'.lVL  .•'.'. 1 921 

Naval  Medical — 

assignments  to 3216, 3217 

attendance  of  Medical  Reserve  Corps 259-261 

bacteriological  examinations  by 3221 

bacteriological  supplies  from 3228,3556 

chemical  examinations  by 3223 

duties  of  faculty 3212, 3213 

duties  of  medical  officer  in  command 3211 

duty  status  of  students 3219 

establishment  of 3201 

examinations -. . . ; 3214 

instruction  by  correspondence 3230 

library  regulations 3220 

mailing  cases  supplied  by 3227 

Medical  Reserve  Corps  ordered  to 3215 

microscopical  outfit ;'...':;•.:■.' 3204, 3555 

name  of 3202 

pathological  examinations  by .-.  .-.■.■. 3221 ,  3224 

specimens  collected  for .•  ■  L'.'.'. .  .'I'l'; 3221-3227 

subjects  taught 3218 

super\ision  of 3203 

Wassermann  reactions  by 3224 

Screening  of  camps '. 2621 

Scuttle  butt,  care  of 2617 

Sea  duty: 

candidates  to  be  able  to  perform 1959 

exemption  from 5 

physical  qualifications  for 1910 

Seamen: 

deduction  from  pay  for  naval  hospital  fund 3602, 3621 ,  3651 

disabled- 
pensions  for 371 1 

pensions  for  widows  of 371 2 

Secretary  of: 

Tronsury,  estimates  to  be  made  by 27 

War,  Army  and  Navy  Uospital,  Hot  Springs,  Ark.,  under  direction  of . . .  1611 

Beedi,  charpod  against  "Contingent,  M.  &  S." 3400 

Senate,  officers  appointed  by  advice  and  consent  of 1902 

Senior  medical  ofilcer: 

njiliroves  entries  in  health  records 2249 

responsible  for  health  records J'.'^ . . .'.'. 224S 

Sentry  duty,  defects  effect  intorforing  with .". "..' 2069 


INDEX. 


397 


Paragraph. 

.„ 1981,2079 

S«ptam,  nasal,  deviation  of ■  •  ■  • 

Sera:  1392 

appropriation  for g-gg 

obtained  from  bureau 

Service-s: 

ambulance —  _    j240 

for  injured  civil  employees '^i'^^i'il'^''m^  1261 

performed  by  Hospital  Corps '      ' 

Army—  2054 

not  counted  as  reenlistment 20g5 

statement  under  oath  concerning 3371-3378 

contracts  for IO32 

dental,  persons  entitled  to ^    ^328 

divine,  at  hospitals V,nsio?\:^l  oS  ■ou c 3393, 3394 

emergency  requisitions  for 1841-1869 

expeditionary,  landing  force  for 1323 

funeral,  at  hospitals ' " '  ' ggg 

in  emergency 3301-3313 

laws  relating  to  procurement  of 2054 

Marine  Corps,  coimted  as  reenlistment 

merchant  marine —  3737 

liable  to  draft .....*.,    3737 

pensions  for 2085 

miUtarj',  statement  under  oath  concerning 

Naval  Auxiliary—  _  3C,25 

deductions  for  naval  hospital  fund '  ^245 

health  records  for '""  2059 

medical  officer  to  examine " ' ' ''■  ^^^2 

officers  and  men  absent ^^^2 

pay  when  absent 3qj2 

pay  while  sick 3011 

persoimel  in  hospitals ggj2 

venereal  disease 

Kavy—  ___ 2054 

counted  as  reenlistment •  2085 

statement  under  oath  conccrmng 2121-2176 

nav>' yard,  physical  examination  for .:..............      336 

of  Dental  Corps ";,)'-.... 713 

of  specialist  for  nurse ". . , ' 

pension  after—  3753 

ten  years  m 3754 

twenty  years  in 12(54 

probationary,  tune  spent  in  hospital 

PubUc  Health.    {See  Pubhc  Health.) 

records.    {See  Records,  Service.)  332^ 

requisitions,  smps  at  navy  yards '"    2502 

sanitary,  Red  Cross  part  of 2^55 

special,  enlistment  for,  not  allowed ^231 

to  patients,  attendants  only  available  for ^^^ 

Shears,  bandage,  Hospital  Corps  to  carry 

SheU-wound  dressings:  1002,1003 

contents  of I821 

instruction  in  use  of 

Ship-s: 

atnavyyards—  859,3324,3327,3548 

requisitions  from ggO 

suppUes  for S91 

board  for  inspection  and  survey  of 


398  INDEX. 

Shlp-s— Continued.  Paragraph. 

cleanliness  of j .v.  <vii-V.:f-;i} 2642 

drj  ness  of 2542 

dutie.s  of— 

chief  phannacisi - 443 

pharmacist 443 

Uect  surgeon,  inspects  when  ordered 1113 

Form  B  from .  3931 

for  transport  of  sick,  board  to  examine 900 

going— 

into  commission.    (See  Going  into  commission.) 
out  of  commission.    (.See  Going  ouJ  of  commission.) 
hospital.    (Sec  Hospital  ship.) 

hygienic  regulations  of S91 

in  reserve — 

medical  attendance  to  personnel 906 

medicaloutflt .....,p,^y..  864 

requisitions  from 859 

lightingof 2542 

log.    (See  Log.) 

material  surveys  held  when  necessarj- i. ,, . .  _. .  ._.t.  ;-->,-,-.  • 2968 

medical— 

ofBcer,  duties  of 2501-2578,2632 

outfit  for 3-322, 3552 

merchant,  neutrality  when  carrying  wounded 4220 

on  detached  service,  requisitions  from 859 

permission  to  leave ..;.... 884 

receiving.    (See  Receiving  ship.) 
report— 

from  medical  officer  of 4121 

of  inspection  of  Medical  Department 4111 

of  sanitarj'  inspection  of 4111 

requisitions  for  supplies 3531, 3541, 3548,  3.j54 

returns  of  propKirty  from 1144,3.'>24 

sailing  of,  patients  left  in  hospital 1235 

sanitary  condition  of 891 

report 1 138, 1 140, 2(32, 2C53 

temperature  of 2542 

ventilation  of.  .• 2542,2002 

Shipments,  hospital  ship,  regulations  for 1"27 

Shipping  articles 2081 

Shipping  order ^999 

Shore: 

stations — 

duties  of  junior  medical  oihccr 1*19 

duties  of  medical  officer 911,931-938 

sanitary  report : 909 

water,  examination  of ,, 2569 

Sick:  

iKiy- 

mcdical  ollicer  in  charge  of .&..>:<>>..  t>44 

recorder,  hospital  apprentice  detailed  as 473 

call— 

absentees  reported I-IOO 

hospitals < 1348,136^ 

care  of,  In  field -.'.<. 1801 

charges  for  tran.sportation  of 73 

condemned  by  survey,  sending  home 2911 

cvacuutlou  of 1M2, 1849, 1801 


INDEX.  ^^^ 

Paragraph. 

Sick— Continued.  2944,3010 

expenses  of  transportation  to  hospital 3729 

furlough,  pension  status  when  on ;•■::■•■":"■ ' ' ' '  * g^ 

Hospital  Corps  attention  to • ' .............!...    2565 

inspection  of  food  for 

leave—  2909 

board  of  survey  required 2266 

health  record  forwarded  to  bureau ■ :  -  ■ : 3729 

pension  status  when  ou 

list— 1034 

dental  patients  admitted  to ::•--:::••:• 2252 

venereal  diseases  must  be  admitted  to ."'...    1491 

oflacers,  hospital  routine  for ^445 

records  of  nurses  kept  by  chief  nurse ' '    j^gn 

removal  to  hospital  when  recommended 

reports  of—  817,872,933,904,3908 

daily "     ' 1348,4121,4131 

"l<"™»^g 1149, 1256,3909,3922,3940,4121,4131 

:'.,,,    ,0  sta-tistical ■••■•  1145,1238,3907,3922,3939,4131 

;'       ■     weekly ■■ ■■"■  1281 

responsibility  for  care  and  treatment  of 

sent  home  in—  3007 

chartered  ship ........    3008 

pubUc  vessels  if  practicable ......--- [..... .      860 

stores  for .....--.-..  3001-30II 

transfer  of,  instructions  regarding ^^^ 

transportation  of,  on  distant  service • - ^^ 

transports  for,  to  be  examined ' " '    ^.^q- 

wards  respected  in  fight  on  warship 

Sickness: 821 

certificate  of ....-■■-  ^^^ 

of  nurse,  report  of ' " 3352,3368 

officers  to  report 17^ 

Signals,  used  on  hospital  ship ■ ^723 

Signaling,  instructions  in ^g^g 

Signalmen,  reinforcement  of  stretchermen  from 2769 

Silks,  disinfection  of 

Sites:  2621 

for  camp,  selection  of ^^lOii,  3012, 3659 

hospital,  authorized  by  Congress 

Skin  diseases:  2061 

examination  for 1901, 1981, 2079 

rejection  for ig^il^  2079 

Skull,  deformity  of,  rejection  for 3^^ 

Slip,  transfer  and  discharge 

Smallpox  (see  vaccination):  ^^^ 2061 

examination  for  evidences  of - -.•.-.;■•. ■.-.■.-.-.■.■:■." ■ : : r"'"' '•='■'  ] '^'"'"  ''*'''■  ^344 

landing  force  protected  against -—^--'ii-'!!- ?--■**-■ -■■■■".•'--•••  ^g^j 

precautions  against - 2612 

protection  from,  by  vaxicination 2731 

quarantine  for 1 527 

Small-store  requisitions,  preparation  of 

Smoking:  ,,,-i.  s, ^-^^ 

in  bed,  prohibited . . .  ^ ^ ! 1508 

places  designated  for ^  ^733 

regulation^,  hospital  ship J3g2 

rooms,  inspection  of 2781 

Sodium  fluorid,  use  as  insecticide 21.50 

Soldiers,  honorably  discharged,  preference  of 


400  INDEX. 

Spaces:  Paragraph. 

confinement,  report  of 898 

living,  inspections  of 855 

Special: 
diet— 

from  wardroonj  mess 3422 

list 3913, 3961 

list,  revised  daily 1233 

sheets,  inspection  of 1325, 1344 

duty- 
death  while  on 2435 

ofi&cers  detailed  lor 1352 

physical  examination  for 21I1-211G 

quarters  for  nurses  on 751 

staflofflecton '..' I'l  .''.■.".'!'...  J 1121,1122 

exigency  public  bill- 
to  be  avoided 3393 

use  of 3394 

forms  used  in  hospitals 4001,4002 

nurses,  employment  of 623 

ratings,  physique  of  applicants  for 2067 

service,  enlistment  for,  not  allowed 2055 

Specialist: 

t  reatment  by 3354 

treatment  of  nurse  by 713 

Specifications,  Navy  standard  to  be  used 3377 

Specimens  for  Naval  Medical  School 3221-3227, 3229 

Speech,  Impediment  of,  rejection  for 19G1, 1981, 2062, 2079 

Spine,  curvature  of: 

entered  on  report  of  rejection 2081 

examination  lor 2061 

rejection  for 1961, 1981, 2079 

Spirits,  distilled: 

custody  of 827 

in  medical  stores 801 

Spit  kids,  dismfection  of 2753 

Splints,  application  of 1864 

Sputum: 

disinfection  of 2753 

disposal  of 2615 

Staff: 

of  commander  in  chief 1111 

composition  of lUl 

correspondence  and  requisitions 1131 

battalion,  post  of,  in  parades,  etc 1851 

division,  duties  of 1172 

officers,  exempt  from  sea  duty 6 

petty  officer  with  brigade  surgeon 1161 

regimental,  post  of,  in  parades,  etc 1854 

reviewing  officer,  post  of,  in  parades,  etc 1854 

salutes  l)y 1854 

Stains,  blood,  procured  from  Naval  Medical  School 3228,3556 

Stamps,  diargcd  against  "Pay,  miscellaneous" .    3400 

Standing-order  sheet 3968 

Statement: 

of  cost  of  maintenance,  hospital 1421-1425,4131 

shall  accompany  estimates 28 


station: 

aid — 

battalion  sui'geon  to  establish 


INDEX.  401 

Paragraph. 
1844 


1866 

temporary "- 1824,1827 

battle  dressing -■- ^^^ 

brigade  dressing,  location  of ^^^ 

changes  of,  nurse ^^^ 

chaplain's,  in  battle 

dressing—  ^^g_ 

designation  of „ 

fi«id :;::  ^^ 

temporary...... 91 1;  912, 919,931-938 

duties  of  medical  officer  at "^'""^  '      ' 

foreign—  ^^^  ^g^g 

examinations  ou ' 

public  bills .......-.■- ^^^ 

journal  kept  by 

medical  officer— 

at  quarters ----- ---• ■ ^^^ 

during  battle - ■""■■■•"^-^^]^r.::':::^i-2m7 

duties  of 

nurse  not  to  be  called  from - 

pay  divMon  in  battle .■.".■'igea.lSM 

regimental  aid 

reports  and  returns  from ■  •  • 

requisitions  from ' 

sanitary  report-  ^.^ 

'"°°*"y 2634,2652 

yearly  


supervision  of  hygiene  of .  _ 

surgeon's  division  at  quarters : . .  

unhealthful ,  sanitary  precautions  ou 
Stationery,  appropriation  for  


2591 
S69 
2515 
1397 
1982 


2371-2391 


Stature,  candidates  for  Naval  Academy 

Statistical  report  of  sick,  preparation  of ^^^^ 

Statistics,  vital  of  Navy ;■.  ^  Z 2751 ,' 2767,' 2771, 2772 

Steam,  disinfection  by ""      '        '        '^^^^ 

Sterilization  of  mess  gear '    '^ 

Stsrilizers  for  dressing  stations ^^^ 

Sterilizing  apparatus,  care  of ■■":■"■"    „„, 

Stigmata  of  degeneration,  examination  for ''^ 

Stimulants:  ^ 

Hospital  Corps  to  admhaister 

intemperance  in  use  of,  rejection  for ■ ; ','  _ 

Stores  (see  Property;  Supplies):  ,u.„ !.,.::»  43, 

accounting  of,  before  discharge - •  •  - ••  • 

destruction  of,  necessitates  survey ^^^'  ^ 

hospital,  record  of 

inflammable,  care  of -' 

inspection  of,  entered  in  journal ■■■         - 

loss  of,  necessitates  survey ^^^^' 

medical.    (See  Medical  stores.) 

receipt  of,  entered  in  journal I^a  I-4 

responsibility  of  Hospital  Corps  for  care  of ':^, 

return  of,  Form  V • 392-2, 3950, 4131 

SlSf".™.  -  -  -  -  ^^ ^ - ' ^  -  -  -  •  -  -  ^  ■  ■■  •   -  •    ■    -   -  ■  •  865,'3502,"36n,'35i6, 3519, 3520, 3903, 3905, 4121, 4131 

98601°-  17 20 


402  INDEX. 

storerooms:  Paragraph. 

inspection  of 856 

medical,  precautions  regarding -i^inrja  w.-it,-«J»i,aAi  •  •      826 

Stoves,  allowance  of,  Nurse  Corps vh^ioq ffld)  •  •      751 

Stragglers,  health  records  of 2291 

Stretcher,  splint,  requisitions  for ,,,.. 3421 

Stretchenuen: 

brassards  worn  by ;..•,.;, n.^j,-,. 1846 

detail  of,  to  be  permaneut 1845 

duties  during  battle 1822 

instruction  of ....................... 1821 

litters  for „,,..,,,....,,,,,,.,.., 1846,1854 

parade  formation u^t^tHia-i-u!' 1854 

reinforcement  of,  during  engagement , 1848 

Stricture,  candidate  rejected  for ,.......,.  „i,.. . .  1901,1981,2079 

Stub  requisition  form 3<)93,41.H1 

Stuttering,  rejection  for l  .    2079 

Submersion,  classification  of 2336 

Subscriptions,  entry  in  billljook ,..._..... 1402 

Subsistence : 

employees  in  hospitals 3t)l4, 3657 

militia  in  hospitals ....^.. ,.......,..,._.,......,..,... fus^ilK-iiHO 1268 

Nurse  Corps ,.. 721, 741 

report,  Hospital  Corps 3964,4131 

stores,  sale  of,  to  nurses 732 

Sugar,  urine  of  candidates  test  ed  for 1955, 1993 

Suicide,  injuries  by 2335 

Sulphur  dioxld,  disinfection  by 2752,2761-2768,2781 

Summary: 

court-martial,  indorsements  on  record 829 

court-martials,  ordered  at  naval  hospitals .---.■■- 1277 

of  requisitions  shipped 4131 

Sun,  exposure  to,  to  be  avoided 254i), 2609, 2621 

Sunday,  inspections  and  musters  must  not  1)e  hold  on , 1285 

Sunlight,  disinfection  by -.-  r  .-.-*o  .ioj^cm)- 2751 

Sunstroke,  ambulance  parties  prepared  fijr 1854 

Superintendence  of  naval  hospitals 3610 

Superintendent  of: 

St.  Elizal>elhs  Uospilal  for  insane 3103,3131 

Nurse  Corps—  . 

allowances  of ».,>/;,. ..a n., 730,751 

duties  of 615 

medical  treatment  of '. 7 1 4 

pay  of 'iO^ 

Supernumeraries : 

applicants  for  enlistment  admitted  as 2tK>4 

deOniiionof ...,,,.j,....j.jj,,......,,.,',»vi..-*<w.iiii.«*fi.,.i.i'." 15;^ 

health  records  for ,..., ■-...•j..iw..  2247, 229.'! 

in  hospital,  instructions  regarding : 1631-1535 

natives  of  insular  j)08sessions t-- 2247 

not  entered  on  Form  K 2375,2391 

nurse  reported  as 711 

pensions  of,  in  hospitals  or  naval  home 3623 

report  of  retention  or  Hilmlssion  of ^►.,i„,.,.,i..<4>.  4131 

Bnppllei.    (See  I'roperty;  .Stores.): 

lidvcn  isemciit  for 3302, 3^172 

Ijuctoriological — 

from  Naval  Medical  School r •■  ■    '^'^■^ 

requlsil  ions  for 3656 

bureau  has  oustofl v  of 3321 


UNDEX.  403 

Supplies— Continued.  Paragraph. 

contracts  for—  3305 

how  controlled 3:j71-3378 

how  made 3308 

to  be  in  writing 2953 

death  of  officer  in  charge  of -  ■  - 3334 

disposition  when  going  out  of  conraiission 3393, 3394 

emergency  requisition  for -^ 3323 

from  other  department  of  ship 3306 

furnished  by  contract ' " ' ' g60 

in  emergency 3330 

inspection  of 3303 

issueof 3525 

to  persons  not  in  Navy '  1420,3301-3313 

laws  relating  to  procurement  of 

medical  (see  Medical  stores)—  .  nr  ■  •»<•  > « i:  ■   goo 

allowance  of 918 

at  navy  yards ' ' ' 3517 

errors  in  invoices  of 864 

going  out  of  commission '.■.".'.'.'.';':". 934  1225,1284 

inspection  of 858 

invoices  of 3322 

outfits  for  ships ' ' ' ' 186I 

providing  of,  in  field ■• 858, 3513, 3516 

receipts  for "     ' " ' 3533^  3541-3-548, 3901 

requisitions  for ' ' 904^  93.5^  3533 

select  ion  of ' '     3503, 3541 

ships  in  conunission 1850 

transportation  of i_^'  _J^';]'-_'_ _ _•_ 3555 

microscopical,  requisitions  for g^^^ 3^22 

miscellaneo\is,  requisitions  for 33q9 

oath  to  contract  required 

open-purchase  requisitions  for—  .3.305^  3326 

from  ships 3328 

on  shore • 3331-3333 

public  bills  prepared  for 3303,3307 

pinchase  of 33OI 

regulations  concerning 137I 

replenishment  of,  in  hospitals •  ■. ' ' ' 332^ 

required  for  by  bureau 39:«,  4121, 4131 

requisition  for,  Form  4 ; : 3523 

responsibility  for  loss  of • '   ' 2519 

restriction  of " 3329 

selection  of 3324,3327 

ships  at  navy  yards 86O 

transfer  of,  between  departments 

supply  depot,  medical.    (See  Medical  supply  depot.) 

Supply  table:  860 

allowances  based  on 3544 

articles  not  embraced  in '  "^ '  ' 3515^  355^ 

basis  of  supplies ;--V-'i"''Vri;'"'''"!'"'"""" 3551-3556 

instructiom  relating  to ■^■' 3542 

packages  designated  hi 2271 

Surfaces,  teeth,  classification  of 

Surgeon-s:  163 

appointment  of 

battalion.    (See  Battalion  surgeon. ) 

brigade.    (See  Brigade  surgeon.)  gQ2 

commanding  officer  to  consult 


404  INDEX. 

Surgeon-&— C4)iilinued.  Paragraph. 

ilivjsion— 

dental  officer  part  of 331 

duties  during  drills 981-987 

personnel  of 870 

station  at  quarters 869 

examination,  professional,  for  promotion 211 

executive.    (See  Executive  surgeon.) 

general- 
death  report  signed  by 2435-2438 

personal  memorandum  for 4121, 4131 

to  assign  nurses 671 ,  675 

regimental.    (See  Regimental  surgeon.) 
Surgical: 

appliances- 
replaceable  only  after  survey 2951 

survey  of '*62 

cases,  supervision  of 1350 

instruments- 
appropriations  for 139S 

survey  of 862 

operations,  necessity  for 1287 

ward,  supervision  of 1350 

work,  opportunity  of  junior  medical  officers  for 12^7 

Suivey-s: 

board  of — 

entered  In  journal 1362 

for  ships ^91 

material.    (See  Survey,  property.) 

medical 822 

board  of 891 

discharge  upon y-^-- 1236 

discharge  upon,  not  in  line  of  duty 2906 

entered  in  health  record 2^86 

health  record  signed  and  verified , -7 -i;: r,- - »>»r 1237 

line  of  duty  statement - 2821 

medical  officer  notified  of 2302 

name  of  ship  to  be  noted  in , 1236 

not  required  for  transfer  to  hospital 2925 

officers  in  hospital 291 1 

of  general  court-martial  prisoner 2947 

of  insane  persons 3124,312.%  3128, 3129, 3165 

of  patient  in  hospital  3  montlis 126,-.,  1286, 294s 

order  for 3910 

patient  recommended  for 1528 

regulations  relating  to r,Mf,t,- •-•'f.tr - 2901-2916 

report  of .'......'......  1142,2931-2937, 3911, 3922,3»43, 4121, 1131 

request  for 2921-2925, 3922, 3942, 4121, 1131 

sending  home  sick  condemned  by 291! 

to  Naval  Home 1632 

transportation  of  men  discharged  by 2907 

"f- 

Inianilary  articles 2537 

lostartlcles 3523 

surgicallastrumonts •*''^2 

properly "'^ 

boardof «^'7 

dental 1"'0 

ronnsfbr :=W-^'.      '.  tl21,H3l 

hospitals 1'^ 

inslrucdoas  relating  to 2951-2956,2961-2978 


INDEX. 


405, 


I'iiragraph. 

1S24 

Swabs,  dressiug  station  to  have 2505 

Swimming,  precautions  regarding ■  ■  •  •  v- '  -  •  • ^^^ 

Swords,  surgeons  to  wear  at  parades,  (^ ■  •■ :  •■:■.•.•.".".". " ' 

Symptom-s:  2260,2283" 

noted  in  health  record 22oS 

not  to  be  u  ;ed  as  diagnosis 2079 

SyphiUs,  rejection  for 2307 

abstract  of  treatment  of 

Tabes  dorsalis:  2259 

method  of  entering 2070 

rejection  for 

Table-s:  1232, 

diet,  variations  in - 1962,2084,2082 

of  height,  weight,  and  chest  measurements 2152 

of  height  and  weight  of  civil  employees 

supply.    (See  Supply  table.)  2u81 

Tachycardia,  noted  in  import  of  rejection 'J^.^ 

Tags,  identification,  personnel  to  carry •.■.■.■..■       2097 

how  prepared ...-..-... ^^^^ 

TaUpes  valgus,  noted  in  report  of  rejection •  •    ^^q;. 

Tattoo  marks,  entered  in  descriptive  list 4291-4297 

Taxes,  hospital  slup  exempt  from 

Technique:  1351,1375 

laboratory,  instruction  in ^375 

operating  room,  instruction  in 

Teeth:                                                                                                                                2271 

cavities  in,  classification  of 2271 

classification  of 

defective—  20S1 

entered  in  rejection  report jgg^ 

to  be  filled 2073 

waiver  for 2271 

filling  material,  classification  of jgei^i^S  1.2079 

loss  of,  rejection  for 

missing—                                                                                                                          2103 

entered  on  descriptive  list 2241 

entered  on  health  record ^g.,  2073 

requirements  for  candidates '2271 

surfaces,  classification  of ^ 3^0^, 

Telegrams,  charged  against  "Pay.  miscellaneous" 

Telephone-s:  34OO 

charged  against  "  Pay,  miscellaneous" ^g^g 

request  for  extension  of  leave ::  '.".■.:  ^  1  ■.■.'■'.' " 

Temperature:  m  920 

certificate  of ■■■ 2542 

of  ship 2002,2003,2065 

Term  of  enlistment 

Testicle :  2072 

enlargement  of,  rejection  for ' '  ^(,511981. 2079 

undescended,  rejection  for " '  ^^ 

Tests  of  water jOU 

Thigh,  first-aid  care  of  wounds  of ::  ;.■■:::: ' 2070 

Thumb  loss  of,  rejection  for : : " ." : : : ' : 

Ticket,  hospital :  1325^  1502 

disposnl  of 3922,3937,4121,4131 

Form  G 2001  2079 

Tinea  capitis,  rejection  for '  3225 

Tissues,  prpparation  for  microscopic  sl\idy 


406  INDKX. 

Title-s:  ,  ,  Paragraph. 

abbreviai  ions  for 2241 

ofcertain  chiefs  of  bureaus 6 

of  medical  officers 102 

Toe-s: 

deformed,  rejection  for 2079 

hammer,  rejection  for 1981,2009,2079 

Toenail,  Ingrowing,  rejection  for 1981,2009,2079 

Tongue,  mutilation  of,  n-jection  for 2079 

Tonsils,  enlargement  of,  rejection  for 1961,1981,2079 

Torpedo  rooms,  first-aid  appliances  for 1821 

TorticoUls,  rejection  for .". .."..:....." 1961, 1981, 2079 

Tourniquet,  use  of lOfH.,  1007, 1821, 18M 

Towels: 

appropriation  for 1397 

for  dentist's  office 1042 

Traffic  by  hospital  ship  forbidden , ■ 1713 

Transfer-s: 

abbreviation  for .■;....■.■...■.■..■.. — ". :.. 22^-' 

accounts  on .".■;.'.■.■.■..■..■.■:..'.■....■.■.■■ 2989 

allotments  after 298S 

and  disc'.iarge  slip 39S-1 

date  entered  in  health  record ■ 2203 

of  dead ^..j^_..^....., 174(1 

entries  in  service  and  health  records —  '  .....'^y'. 29^*2 

examination — 

before "^^ 

entered  in  health  record 2202 

health  record — 

accompanies  patient ..» ....» 2201,2993 

entry ...■;;.....:..;....... 222:1, 2261, 2281, 2284 

forwarded 2266 

of— 

Hospital  Corps,  report  of 487, 1288 

insane - -   ■  - •  ■  ■  •  3125-3127, 3133, 3135 

labor,  request  for 3994,4131 

marines 1 1 .....  ^ 2990 

medical  stores '.'.'...'.'.'.'. 3903 

men  with  venereal  disease 2116 

nurses 073-677,728,729 

ofTicer,  medical  officer  notified  of ^^  2212 

ofhcer  to  hospital  to  be  reported .........  ^j.^^. ......,,.,,,,...........    1221 

officer  to  naval  home A-V-  tiI;  •  (•■.fiVif- ^^* 

pat  ients  l)etween  wards ■ .' 1522 

patients  to  hospital  ships •  •  1"45,2926 

patients  toother  than  naval  hospii  111 -i 4111,4121,413! 

siclc  and  disabled,  instrucHons  repanliu-' .i;.;'.'.;^^... 3001-3011 

stores >"'>5, 3')02, 3-511,  ;«16, 3519,35520, 5005, 4121, 4131 

supplies  between  departments ^''^O 

tuberculosis  cases 2987 

I0  Volunteer  Naval  ^esc^^'o  Force. .  3C1 

papers  to  Ik-  transniitled 2984 

physical  oxaniinatlon  before .  21  U>,  2983 

recruits  vaccinated  before 2032 

to  hospital S22-.S24, 1113, 1211-1217 

Civil ^24 

corps 401,183, 4SS 

Inst  ructions  Rovcming •  2i)8i-30i  i 

other  than  United  States  n^val 2985 

report  ed • tSSn 

ViKciniition  f>fre<Tiiils  before 2082 


INDEX. 


40' 


3335 


Trausport-s:  '''''''''''^., 

Army,  health  records  on ; .iV-.^niii -^ 

cohimn,  organization  of ^_" 

divisions,  training  of '"^ 

for  sick,  board  to  examine 

medical— 

Red  Cross  personnel  on *^^ 

transfer  of  wounded  to : ■'" 

of  wounded  to  be  neutral 

Transportation: 

allowances.  Nurse  Corps f.24,72i,7hl,7ti2 

*'^-  73 

sick  and  insane  patients -■ 

sick  to  hospitals,  expenses  of -■'''^' ^"^''•- 

dead,  charged  against  " Contingent.  M.  .t  S." --- 3433. 

dead  marines »  o^'^!'olt^ 

discharged  prisoners :::!.'iL':i^: o611,36^. 

...  3133,3156 
insane '  ^ 

men  discharged  by  medical  survey •  ^ -;J"' 

Red  Cross  personnel ■ "" 

remains — 

appropriation  for 72,3435,3437,3439-3443 

'^  f  .     2405 

expenses  ol : 

/  ,  985,1830 

wounded ' 

during  lull  in  battle -  •  •    ^^^'^ 

methods  of - ...1821,1830 

in  distant  service • . 

regimental  quartermaster  provides - ''' 

Traumatisms, classification  of - • • ■-■ 

Traveling  allowances,  Nurse  Corps "^'  '-^' '"''  '°^  - 

Treasury,  Secretary  of,  estimates  to  be  made  by 

Treatment:  _. ,  ,„., 

,  •  1-  t  J  ■  '  13,33oo 

byspecialist =..•.•.-.■.... '        - 

consultation  regarding —  •  •  -  ■  ---•-•--- 

dental —  ^^ 

abstract  of ^ 

entered  in  health  record "uJiJi^^.u  "■"""■■"  "^  ■    "ic'' 

officers  to  keep  records  of - :-...  J^-r 

,      ,  102C),  1055-1037 

records  of ' 

employees  in  naval  hospital ■ '    „ 

entered  in  health  record ~""'  ^^"^ 

hospital— 

of  applicants  for  enlistment """^ 

when  no  naval  hospital 

1208 
militia  in  hospital 

nurses—  . 

CTT  ! '  by  specialist '  '■' 

'^^' ''     entitled  to / ^^ 

.  .    ,    .  13()8 

prisoners  m  brig 

sick,  responsibility  for 

syphilitic,  abstract  of 

Trees : 

charge  against  "Contingent,  M.  &  S." ---- --'•■ \ 

no  change  to  be  made  in -•---■- .•.■.•..■.■...•.•.'.■.....' 122  ,  "^ 

Trephining,  evidences  of ,  rejection  for ^  '■ 

Troops:  .      ^„,j, 

embarked,  precautions  as  to  health  «( '^■^'  -^  - 

exemption  from  quartering  of '" 

"informed  of  provisions  of  Oeneva  Conventions '-' 


108  INDJiX. 

Tropics:  Puragraph. 

bulhiiig  precautions  in. . .  2605 

ho.ilth  precautions  in 2522,2613 

Trunk-s: 

(ILsinfoction  of 2769 

standard  army,  dimensions  of 1847 

steamer,  for  expeditionary  servir*' .• 1847 

Tuberculosis: 

ypplicanl  rejected  for 2079, 2148 

cases,  removal  to  hospil  al 1212, 2987 

detail  of  patients  with ,....» j^w i. 1313 

examination  of  candidates  for 2061 

precautions  against 2615 

report  of  cases  of 4002 

Turrets,  first-aid  appliances  for ■. .>,. y, , $; .  j;f-,.j.t,i.Mfi-'.> ^..-nU ><>•■■  i- 1821 

Tympanic  membranes,  examination  of 207C 

Typewriters,  appropriation  for  at  naval  hospitals 1395 

Typhoid: 

bacilli,  emulsion  for  Widal  test 3228,3556 

precautions  against 2603,2612 

prophylactic — 

all  persons  to  receive 952, 1943, 1997, 2577, 2612 

entered  on  Form  K , 2380 

entered  on  health  record .....,, 2227, 2253 

instnictions  concerning ...a 2087 

landing  force  to  receive 1844 

method  of  obtaining 3562 

recruits  to  receive .,,^.^,  ,.,.*.,.,.,,.> 2033 

protection  from  flies -■---•  •-.-.-;.> r^hIi.-*;, 2615 

report  of ->,.>!«.> ^^-.■.,.^ 2012 

Typhus  fever,  quarantine  for ..^,..j,5-„t..,...4.,« ;..►,, 2731 

Ulcers,  chronic,  rejection  for 1981, 2079, 2148 

Unclvllzed  enemy,  ambulance  jv.nly  armed  against 1845 

Underclothing:,  clean,  put  on  before  battle 1825 

firpproofing  of ." 1825 

Underslze,  rejection  for 1982 

Undetermined.    (See  Diagnosis  undetermined.) 

Unfit  for  duty,  transfer  to  hospital 822 

Uniform: 

adapted  to  weather  and  climate 2605 

for— 

acting  assistant  surgeon 152 

Dent  al  Corps n,,.,,  .rH,«.  ,f,ni  t 322 

Dental  Resen-e  Corps .j^^.j.  ,.^i  ^,  v ^58 

Medical  Reser\-e  Force .'..",'."-'.•.••. fMr 245,260,261 

gratuity  for 1825 

Nurse  Corps .._.._........ . .  trii •  •  771-774 

If (jspital  Corps,  to  be  inspected 1320 

hospital  shij),  rogulat  ions  for 1727, 1731 

landing  force,  to  be  prescribed 1845 

liberty  part  ies  to  be  inspet  led •>,,  ^om-, 1504 

medical  ofTlcers  with  expeditionary  force 1847 

Naval  Uoserve  Force ...w. ..,,,,*,„,/»••. 304 

patients  always  to  wear ..„..,,,. 1516 

prescrlbe<I  by  executive  surgeon , 1304, 1332 

regulations  to  be  observed  in  hospitals 1290 

service,  to  Ije  worn  in  hospitals 1332 

United  States : 

not  cxemia  from  liability 2167 

status  when  making  contract ^"^74 


INDEX.  409 

Paragrapii. 

ITrinalysis  required  in  physical  examinations >:..,. ..,„.,h, 1955,1998 

Urine:  ..«»■/ 

disrofection  of 2753 

incontiaence  of,  reject  ion  for .,.»,. 2079 

Utensils,  eating  and  cooking,  disinfection  of ..,^,,.;^,(. 2772 

Vaccination: 

duties  of  medical  officer  in  conneotion  witli 843 

entered  in— 

FormK 2380 

health  record j^,.,t»*> ,*.«.,*.... .  .v.  2226,2253 

journal 231S 

every  person  to  have 2612 

examination  for 2061 

instractions  concerning 2086 

landing  force  to  have 1844 

of— 

crew  on  going  into  commission 257('i 

recruits 951,2031,2032 

recruits  to  receive- 
before  transfer 2032 

immediately v ...-yf-.j... 2031 

Vaccines: 

appropriation  for 1399 

instructions  relating  to 3561-3503 

Valises,  disinfection  of -r 2709 

Valuables  of  patients,  to  be  safegniarded 1330, 1464, 1514 

Varicocele: 
entered  on— 

health  record 2241 

report  of  rejection 20fel 

examination  for 2061 

rejection  for 1961, 1981, 1985, 2071, 2079,214* 

Varicose  veins: 

entered  on  report  of  rejection 2081 

examination  for 2061 

rejection  for 1961, 1981, 1985, 2071, 2079, 214S 

Vegetables,  precautions  when  night  soil  is  used 2604 

Veins,  varicose.    {See  Varicose  venis.^ 
Venereal: 
disease — 

circulars  relating  to .........._..._._.............. ...r-,.^..^..---    2252 

detail  of  patient  with j,j,.>y^£[y.i„,',.„jj^jj...    1313 

entry  of  sequelae  of .^^},,j,.f„5»j,-^j^.^5,. ..,   2259 

examination  for >, 2061 

men  with,  not  to  be  transferred i., , 2116 

must  be  admitted  to  sick  list 2252 

not  treated  at  Army  and  Nav\'  Hospital 1611 

patients  not  allowed  liberty .^ ..,  j.^, .  .^ .,  1505, 254:; 

patients  not  to  be  in  landing  force. ......... ..... .;^|i^.,j.;jj,,j^f  -^,j,...,g. ,,.;.;  .(j,j„.  ..p., 1844 

patients  not  to  be  transferred 5„,^,,f,i^ ,,.-w., .  y,,:. -j..^.  ^,. .:. . ,    2116 

rejection  for .^.^.^^^lllll^^ll^^l^Ll^' ^^■V....^...„*-w,^^y^,^...:„^'.  2079,2148 

See  Syphilis  abstract i 2307 

prophylaxis,  report  of 11&) 

wards,  nurses  not  detailed  in 1453 

Ventilation:  ...'.... 

dressing  station  to  have 1824 

ofship 2542,2602 


410  INDEX. 

Paragraph. 

Verification  of  records  on  going  into coiniiiisvji.ii .;■.';*.'?.'.".  ■?".■!*.: 'J: I .'•. . Tf .■■; l; .V. 848 

Vermin : 

destruction  ol 2763 

examination  of  applicant  for _ 2061 

rejection  of  applicant  for '.'1 2079 

Vessels  of  Navy: 

officers  of,  to  be  citizens 1^1 

subject  to  quarantine  inspection 2732 

Veteran-s:  

furlough,  pension  status  when  on -...■.:■.■.■.. 3729 

of  Mexican  War,  pensions  of -.•.•.•.•.-.•..•....i 3715 

Violent  death,  proceduie  in  case  of ; .:  ..■.•..■..:..•.:•.;-.:•.!::•.; .  2423 

Virus,  vaccine.    (See  Vaccines.) 
Vision: 

defective — 

degree  of,  to  be  stated ..rr'*'2064 

entered  on  report  of  rejection m?Ji  Pfl  .'T?T?. .    2081 

examination  for ...;..::::.-.•... 1984 

rejection  for ::V'lWl,t^«1, 2079, 2148 

entered  in  health  record 2241 

examination  of,  for — 

aviation 2!l3 

enlistment ..•.•.■.-:.•..• 2074 

gun  pointer --.-^ (171. 2n:<4. 2111 

requirements,  examination  for  promotion •. 1959 

standard  for  admission  to — 

Naval  .Academy •■ 19S^ 

various  corps -  ■ 19«S 

Visiting  hours  to  be  designated  at  hospital 1331 

Vital  statistics  of  Navy • 2334 

Voice  used  in  test  of  hearing ...;...... IflftS,  19% 

Volunteer  Army,  admission  to  Ariny  and  Navy  Hospital ..■.■.•.•.•.-.•:.■ 1011 

Volunteer  Naval  Reserve '^^^'-  "MC 

Vouchers: 

how  prepaicd  and  filed —  13s«"i 

for  commissary  stores Hl2 

preparat  ion  of Xi32, 3392 

receipt  and  cxijendituro  for  commissary  ledger 3960 

Wagons,  charged  against  "Contingent  M.  c<  S." '. -'^OO 

Waiting  orders: 

<lenth  wliilc  on 243o 

luailth  record  of  officer  on 2302 

Waiver  of  physical  defects '.M^>,2<n?,i 

.ntryof mv2, 2081, 2241 

requested  on  report  of  rejection 20«i4 

to  be  recommended 2(X>4 

War: 

casualty  rate  in '"22 

inerchimt  marine  service  liable  to  draft •*'^~ 

Mexican,  pensions  of  veterans  of •''l-' 

Red  Cross  cooperation  in '^' 

Hebellion,  pcii-sions  of  honorably  discharged  men ;;;....;. .  •'733 

staff  officers  not  exempt  from  sea  duty  in... •'' 

Ward-s: 

(.leunliness  and  good  order  of '  "'*' ^**' 

duties  of  nurses  in  charge  of .:;.■■..: MSii 

forms  kept  by  ward  officer ■. ..•.......•.■.•.•..•.•••.•.•.•.•.;•.;•.•.■. •.;:.!..■  ■     1'I2 

in,sjHH;tlon  of '*''^ 


I^NDEX.  4  1  1 

Ward-s— Continued.  Paragraph. 

isolation,  care  of 1316 

management  of U.')tj-1470 

medical  officer  in  charge  of 1228 

nurse.    CSee  Niu-se,  ward.) 

officer,  duties  of i:iU-130i 

order  book  kept  by  nurse ■.-.-.-.•Toi-i)Mtcfeft-feHwr- 1"''' 

patients- 
assigned  to ^y.)r)^.,ytr,..         13(j7 

restricted  to _._..j(,.v^^,«,,j,j.yj,;.i^)^.    1466 

property  book  kept  by  nurse 1467 

psychopathic,  care  of ........................,..,..: i;ilG 

quiet  required  in - 1513 

routine,  daily 1470 

special,  property  responsibility 1349 

surgical,  supervision  of ,-rTRio  trnsiwirt-TOP '-^^ 

transfer  of  patients  between .j,. i.i'^ 

venereal,  nurses  not  detailed  in 1453 

washing  clothes  ui,  prohibited .....fr,,^f,.j.,,^jg,^^ma<:'.-ne^^'-'* l''!'^ 

Wardroom  mess,  special  diet  from — 3422 

Warrant  officer,  health  record  for 2243 

Warts,  rejection  for 20(« 

Washing: 

clothes  m  wards  prohibited lol'i 

stands,  dressing  stations  to  have 1824 

Wassermann  reactions  by  Naval  Medical  School 3222 

Watch  test  of  hearing itfti,  looc, 

Water: 

approval  by  medical  oll'icer 2.j  )4 

drinking,  for  battle  dressing  stations .aoiiemt 1824 

examination  of,  entered  in  journal 2315 

harbor,  use  of,  on  decks :i>«.>t-.r,  ,W2, 2545, 2603 

precautions  concerning .;.■.;....... 2603 

purification  of,  by  calcium  hjT)oclilorite ....................,..,,,:.,,. 2621 

shore,  examination  of ...........,.,....,.......,.......;. 25()9 

supply  for  landing  parties , — ,-.->■- m< 1 2621 

t  esting  of : , : ......,,,,,,,,,,,,... 852 

Weakness,  constitutional,  rejection  for ^, ,  ,loi  jwIj. 1950 

Weapons,  ambulance  party  not  to cari\ ,.,.,-.... ..„i^ 1845 

Weather,  clothing  adapted  to 2605 

Weight: 

disproportionate  to  height 2t»83,20S'i 

employees',  table  of 2152 

entered  on— 

health  record ,,, ..■..    2241 

report  of  rejection ....,..,,,,,,,,  itui  jtvatd  i  j. .    2081 

midshipmen,  requirements  for :'.^'.-A  USSH 

table  of 1962, 20S2, 2084 

variation  from  standard  of 1962, 1982, 2083, 2085 

Welfare  of  troops  embarked ....,,,,„,., ..,........;, 8% 

West  Indian  ports,  report  of  epidemics  in 2567 

Wet,  exposure  of  crew  to,  to  l)e  avoided 2543 

Widows: 
of— 

disabled  officera  and  men,  pensions  for •  ■n>mi,,w- 3712 

those  lost  in  •'  Ashuelot,"  pensions  for 3744 

when  entitled  to  pension iT\ .• 3741 

Whisper  test  of  hearing '. 1996 

Wldal  test,  materia!  for - . 3228, 355t; 


412  INDEX. 

Paragraph. 

Wines,  custody  of 827 

2816 
2108 
1401 
2769 


Witnesses  of  accidents,  report  of 

Women,  physical  examination  of 

Wood,  entry  in  bill  book . 

Woolens,  dteinfection  of 

Worli-s: 

convalescents  detailed  fw ;:;;:. -.-.v.' 1313,1507 

dental- 
records  of ........:.;; 1026, 1035-1037 

statistical  report  of .........: 1 037 

laboratory- 
officer  assigned  for 1317 

report  of r.i:>l 

patients  fit  for KWC 

public.    (See  Public  works.) 

surgical,  opportunity  of  juidor  medical  officer  for 12S7 

Worms,  method  of  preservation 3225 

Wounded: 

agreements  between  belligerents  concerning 4233 

aid  to,  by  inhabitants -taoe,  1336 

assistance  to,  when  rendered 1862 

berthing  space  for 1824 

care  of 985, 1808 

in  field 1861-1S69 

classification  of ::..... 1865 

delivery  to  outposts :.'..' '/. 4207 

evacuation  of : . . .  1842, 1840, 1861, 1869 

first-aid  care  of  . . .'. 1009-1011 

hospital  ship  to  care  for 1802 

In  line  of  duty,  effect  on  promotion 1911 

left  in  hands  of  adversary 4232 

medical  officer's  duty  to :;::•..•.:-.;: 1811 

neutrality  of  house  containing 4206 

prisoners  of  war 4233, 4314 

protection  by  captors 4221 ,  4234, 4279, 431 1 ,  431 7 

provisions  for  care  of 1801 

relief  of 818, 1804, 1821-1832 

repatriation  of 4207, 4215 

report  of :  819, 1137, 18ftS,  1808, 3922, 3941, 4111, 4131 

slightly .....:.;  J... 1865 

skull,  rejection  for 2079 

transportation  of ...;.:. I'.^l':^.'. t .". .'fl . .  985, 1830, 1832 

by  hospital sliip .....;. ;....]'.'.*.':1'..;.:^.. .    1802 

during  lull  of  battle ..'^.'1 . . : . . .    182J 

on  distant  ser\ice 1850 

to  be  neutnil 4203 

Wreck  of: 

•■  .Vshuelot,"  peusious  of  widows H744 

•'Jeanelte,"dateof  death  of  those  lost  in.  .■'.74:( 

X-ray  room,  regulation  for l.Vil 

Yard.    (6Vt  Navy  ynrd.) 

Yellow  fever :  ...;..,  i  j  :  - 

lUsinfwIiouatier 2763, 27R1 

precautions  against 2613, 261;'' 

rpiarantine  lor '   2731 


o 


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